TY - JOUR
T1 - Pulmonary artery pressure monitoring in chronic heart failure
T2 - effects across clinically relevant subgroups in the MONITOR-HF trial
AU - Clephas, Pascal R.D.
AU - Zwartkruis, Victor W.
AU - Malgie, Jishnu
AU - van Gent, Marco W.F.
AU - Rocca, Hans Peter Brunner La
AU - Szymanski, Mariusz K.
AU - van Halm, Vokko P.
AU - Handoko, M. Louis
AU - Kok, Wouter E.M.
AU - Asselbergs, Folkert W.
AU - van Kimmenade, Roland R.J.
AU - Manintveld, Olivier C.
AU - van Mieghem, Nicolas M.D.A.
AU - Beeres, Saskia L.M.A.
AU - Post, Marco C.
AU - Borleffs, C. Jan Willem
AU - Tukkie, Raymond
AU - Mosterd, Arend
AU - Linssen, Gerard C.M.
AU - Spee, Ruud F.
AU - Emans, Mireille E.
AU - Smilde, Tom D.J.
AU - van Ramshorst, Jan
AU - Kirchhof, Charles J.H.J.
AU - Feenema-Aardema, Margriet W.
AU - da Fonseca, Carlos A.
AU - van den Heuvel, Mieke
AU - Hazeleger, Ronald
AU - van Eck, Martijn
AU - van Heerebeek, Loek
AU - Boersma, Eric
AU - Rienstra, Michiel
AU - de Boer, Rudolf A.
AU - Brugts, Jasper J.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/8/21
Y1 - 2024/8/21
N2 - Background and Aims:In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups. Methods: The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator. Outcome measures were based upon significance in the main trial and included quality of life-, clinical-, and PA pressure endpoints, and were assessed for each subgroup. Differential effects in relation to the subgroups were assessed with interaction terms. Both unadjusted and multiple testing adjusted interaction terms were presented. Results: The effects of PA monitoring on quality of life, clinical events, and PA pressure were consistent in the predefined subgroups, without any clinically relevant heterogeneity within or across all endpoint categories (all adjusted interaction P-values were non-significant). In the unadjusted analysis of the primary endpoint quality-of-life change, weak trends towards a less pronounced effect in older patients (Pinteraction = .03; adjusted Pinteraction = .33) and diabetics (Pinteraction = .01; adjusted Pinteraction = .06) were observed. However, these interaction effects did not persist after adjusting for multiple testing. Conclusions: This subgroup analysis confirmed the consistent benefits of PA-guided HF therapy observed in the MONITOR-HF trial across clinically relevant subgroups, highlighting its efficacy in improving quality of life, clinical, and PA pressure endpoints in chronic HF patients.
AB - Background and Aims:In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups. Methods: The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator. Outcome measures were based upon significance in the main trial and included quality of life-, clinical-, and PA pressure endpoints, and were assessed for each subgroup. Differential effects in relation to the subgroups were assessed with interaction terms. Both unadjusted and multiple testing adjusted interaction terms were presented. Results: The effects of PA monitoring on quality of life, clinical events, and PA pressure were consistent in the predefined subgroups, without any clinically relevant heterogeneity within or across all endpoint categories (all adjusted interaction P-values were non-significant). In the unadjusted analysis of the primary endpoint quality-of-life change, weak trends towards a less pronounced effect in older patients (Pinteraction = .03; adjusted Pinteraction = .33) and diabetics (Pinteraction = .01; adjusted Pinteraction = .06) were observed. However, these interaction effects did not persist after adjusting for multiple testing. Conclusions: This subgroup analysis confirmed the consistent benefits of PA-guided HF therapy observed in the MONITOR-HF trial across clinically relevant subgroups, highlighting its efficacy in improving quality of life, clinical, and PA pressure endpoints in chronic HF patients.
UR - http://www.scopus.com/inward/record.url?scp=85196771676&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehae323
DO - 10.1093/eurheartj/ehae323
M3 - Article
C2 - 38733175
AN - SCOPUS:85196771676
SN - 0195-668X
VL - 45
SP - 2954
EP - 2964
JO - European Heart Journal
JF - European Heart Journal
IS - 32
ER -
