Contribution To Literature:

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


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).


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


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

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Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

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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