Real-World Clinical Diagnostics of Heart Failure Patients With Reduced or Preserved Ejection Fraction

Figures

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  Figure 1. Study cohort formation. Patients in the primary cohort had one of the inclusion International Classification of Diseases, Tenth Revision (ICD‐10) codes as any diagnosis (*I42.0, I42.6, I42.8, I42.9, I11.0, I13.0, I13.2, and I50), left ventricular ejection fraction (EF) ≤ 40% or EF > 40% and elevated N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) (>125 ng/L) at index. Heart failure with preserved EF (HFpEF) patients were further stratified into EF 41–50% or >50%. Patients lacking the above‐mentioned ICD‐10 codes but presenting elevated NT‐proBNP (>125 ng/L) were included to the secondary cohort.

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  Figure 2. Distribution of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) concentrations (ng/L) in the primary cohort stratified by ejection fraction data to heart failure with reduced (A) or preserved ejection fraction (B). Dashed lines represent NT‐proBNP 125 and 300 ng/L cut‐offs.

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  Figure 3. Inpatient (A) and outpatient (B) medication of angiotensin‐converting enzyme inhibitor (ACE‐I) or angiotensin receptor blocker (ARB) in combination with beta‐blocker (BB) or diuretic, or their combination in patients with heart failure with preserved ejection fraction (HFpEF) (grey bars) and HF with reduced EF (HFrEF) (black bars) at 0.5, 2, and 5 years after diagnosis. Significance indicated between HFpEF and HFrEF groups, *P < 0.001. Inpatient (C) and outpatient (D) medication of ACE‐I or ARB in combination with BB or diuretic, or their combination in patients in the primary cohort (HFrEF and HFpEF patients, black bars), patients with ICD code for HF but no EF data available (white bars), and patients with high NT‐proBNP but no International Classification of Diseases, Tenth Revision (ICD‐10) code for HF (secondary cohort, grey bars) at 0.5, 2, and 5 years after diagnosis. All differences between HFpEF and HFrEF groups in (A) and (B), P < 0.001; all differences between primary cohort and EF missing group in (C) and (D) P < 0.001; all differences between the primary and secondary cohorts in (C) and (D) P < 0.001.