GALACTIC - GALACTIC

Sep 02, 2019
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
Swiss National Science Foundation, Foundation for Cardiovascular Research, Basel Stanley Thomas Johnson Foundation
Date Presented:
09/02/2019
Date Published:
09/02/2019
Original Posted Date:
09/02/2019
References

Contribution To Literature:

The GALACTIC trial failed to show that early/sustained vasodilatation was superior to standard of care.

Description:

The goal of the trial was to evaluate early/sustained vasodilatation compared with standard of care among patients with acute decompensated heart failure.

Study Design

  • Randomized
  • Parallel

A total of 781 patients with acute heart failure were randomized to early intensive and sustained vasodilatation (nitrates, hydralazine, angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker, sacubitril/valsartan) vs. standard of care. Both groups received loop diuretics, beta-blockers, aldosterone antagonists, cardiac devices, and routine follow-up.

Inclusion criteria:

  • Patients presenting to the emergency department with acute decompensated heart failure
  • New York Heart Association (NYHA) class III-IV symptoms
  • Elevated natriuretic peptides
  • Systolic blood pressure ≥100 mm Hg

Principal Findings:

The primary outcome, death or acute heart failure rehospitalization at 180 days, occurred at a similar frequency between groups (hazard ratio 1.07, p = 0.59).

Interpretation:

Among patients with acute decompensated heart failure, early/sustained vasodilatation did not reduce mortality or rehospitalization for heart failure compared with standard of care.

References:

Presented by Dr. Christian Eugen Mueller at the European Society of Cardiology Congress, Paris, France, September 2, 2019.

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Keywords: ESC 19, ESC Congress, Adrenergic beta-Antagonists, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Emergency Service, Hospital, Heart Failure, Hydralazine, Mineralocorticoid Receptor Antagonists, Natriuretic Peptides, Nitrates, Sodium Potassium Chloride Symporter Inhibitors, Standard of Care, Vasodilation


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