{
  "abstract": "Introduction Heart failure therapy withdrawal in patients with recovered dilated cardiomyopathy (DCM) has been associated with high relapse rates, as demonstrated in the TRED-HF trial. TRED-HF2 is subsequently designed to evaluate withdrawal of mineralocorticoid receptor antagonists (MRA) and sodium glucose co-transporter-2 inhibitors (SGLT2i) in a contemporary cohort. Characterisation of baseline clinical and pharmacological features of TRED-HF2, and comparison with the original TRED-HF cohort, is essential for interpretation of trial findings and assessment of external validity.Methods We compare baseline characteristics of patients enrolled in TRED-HF (n=51) and TRED-HF2 (n=41). Demographic, clinical, imaging, biomarker, aetiological, and pharmacological variables at enrolment were analysed. Differences between cohorts were assessed using Mann–Whitney U tests for continuous variables and Fisher’s exact tests for categorical variables. Guideline-directed medical therapy (GDMT) optimisation was quantified using the Quantitative Unbiased Drug Adherence (QUAD) score. Generalisability was evaluated through comparison with published recovered and all-comer DCM cohorts.Results Patients enrolled in TRED-HF2 were similar in age, sex distribution, cardiac imaging parameters, and NT-proBNP levels compared with the original TRED-HF cohort. However, TRED-HF2 participants had a shorter duration since diagnosis and a higher body mass index. Marked differences in pharmacological therapy reflected evolution in GDMT: no patients in TRED-HF received angiotensin receptor–neprilysin inhibitors (ARNIs) or SGLT2 inhibitors, compared with 61% and 63% of TRED-HF2 patients, respectively (both p<0.001). Median QUAD scores were significantly higher in TRED-HF2 (21 vs 8, p<0.001), with 68% of patients classified as optimally treated compared with none in TRED-HF. Comparison with published DCM cohorts suggests partial generalisability of both trial populations, with broadly similar clinical profiles but persistent under-representation of women.Conclusion The TRED-HF2 trial enrolled a contemporary recovered DCM population with substantially higher baseline GDMT optimisation compared with the original TRED-HF cohort. These findings highlight the impact of evolving heart failure therapy on trial populations and underscore the importance of baseline characterisation when interpreting therapy-withdrawal strategies in recovered DCM.",
  "authors": [
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom"
      ],
      "name": "Laziza Askarova"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom"
      ],
      "name": "Abida Laila"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom",
        "Cardiovascular Research Centre and Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom"
      ],
      "name": "Viren Ahluwalia"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom",
        "Cardiovascular Research Centre and Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom"
      ],
      "name": "Saad Javed"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom",
        "Cardiovascular Research Centre and Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom"
      ],
      "name": "Aaraby Ragavan"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom"
      ],
      "name": "John Cleland"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom",
        "Cardiovascular Research Centre and Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom"
      ],
      "name": "Sanjay Prasad"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, United Kingdom",
        "Cardiovascular Research Centre and Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom"
      ],
      "name": "Brian Halliday"
    }
  ],
  "title": "492 Baseline characteristics of TRED-HF2 compared with TRED-HF",
  "uid": "90a4db69-d803-5c08-ae7a-7f00962997b2"
}