RecruitingNot ApplicableNCT06595290

Vietnamese Rapid Acceleration Protocol for Intensifying Drug Therapy in Heart Failure With Reduced Ejection Fraction

Sponsor

University Medical Center Ho Chi Minh City (UMC)

Enrollment

500 participants

Start Date

Aug 1, 2025

Study Type

INTERVENTIONAL

Conditions

Acute Heart Failure (AHF)Acute Heart Failure With Reduced Ejection Fraction

Summary

VN-RAPID is an open-label, multicenter, randomized controlled trial evaluating the safety and efficacy of in-hospital initiation and rapid up-titration of four-pillar therapy for hospitalized Asian patients with acute heart failure (AHF) and reduced ejection fraction (HFrEF). The study compares a standardized protocol of intensified treatment (high-intensity care arm) with usual care in patients with elevated NT-proBNP levels who are not on optimal HFrEF medications. The high-intensity care arm involves initiation of all four pillars of HFrEF therapy (RAS inhibitor, beta-blocker, MRA, and SGLT2i) before discharge, followed by a structured 6-week outpatient up-titration process with frequent follow-ups. The study aims for 75% of target doses for RAS inhibitors and beta-blockers, considering the lower blood pressure tendency in Asian populations. Participants will be followed for 180 days to assess clinical outcomes.

Eligibility

Min Age: 18 YearsMax Age: 75 Years

Plain Language Summary

Simplified for easier understanding

This study (Vietnamese RAPID-HF) is testing an accelerated approach to starting and increasing heart failure medications quickly in patients admitted to the hospital with heart failure and a weakened heart pump, to see if faster medication optimization leads to better outcomes. **You may be eligible if...** - You are 18 or older - You were admitted to hospital with signs of fluid buildup (congestion) from heart failure - Your heart pumping function is 40% or less (reduced ejection fraction) - Your blood pressure is above 90 mmHg, heart rate is at least 60 bpm, and potassium is normal - You have significant ongoing fluid buildup, shown by an elevated blood test (NT-proBNP 1500 ng/L or above) - Your current heart failure medication doses are at or below one-quarter of the target doses **You may NOT be eligible if...** - You have documented intolerance to the required heart failure medications - There are absolute medical contraindications to these medications - Your heart pumping function is above 40% - Your condition is too unstable or severe Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERHigh intensity care

This arm follows a structured algorithm for initiating and uptitrating all four pillars of HFrEF oral medications post-randomization (pre-discharge) and during at least 4 visits over 6 weeks post-discharge.

OTHERUsual care

Patients will be managed by their cardiologist according to their usual practice. Follow-up appointments will be scheduled as per the cardiologist\'s instructions. Participants will return to the recruiting study site for clinical outcome assessment by study investigators at 90 and 180 days post-discharge.