Key result
Early ischemic evaluation in HF linked to ~8% lower mortality, lacking benefit in women and elderly.
Why the study?
The prognostic significance of ischemic evaluation in new-onset heart failure is not well understood and may differ according to age and sex.
Does an ischemic evaluation within 90 days of diagnosis reduce long-term mortality in patients with new-onset heart failure?
Observational (n=61,475)
Does an ischemic evaluation within 90 days of diagnosis reduce long-term mortality in patients with new-onset heart failure?
Hazard Ratio: 0.92 (95% CI 0.9–0.95)
Routine ischemic evaluation in new-onset heart failure may offer only marginal mortality benefits, with no apparent benefit in women and patients over 75 years of age.
Ischemic evaluation in new-onset HF may warrant age- and sex-specific interpretation; leaves open optimal testing strategies.
Background and Objectives:The prognostic significance of ischemic evaluation in patients with new-onset heart failure is not well understood and may differ according to age and sex.In a realworld cohort, we analyzed the long-term mortality risk after undergoing an ischemic evaluation.Methods: All new-diagnosed heart failure patients 2008-2018 without prior ischemic evaluation, known coronary artery disease, or acute myocardial infarction were identified from the Danish National Patient Registry.The association of an ischemic evaluation within 90 days of heart failure diagnosis with long-term mortality was analyzed by inverse probability weighted Cox regression models.Results: Totally 61,475 patients were included (mean age 73.3±13.9years, 46% women), of which 12,503 (20%) underwent an ischemic evaluation.During a mean follow-up of 4.6 years, 37% of patients died, mortality rate 8.0 (7.9-8.1) per 100 person-years.The multivariable-adjusted hazards ratio of death was 0.92 (95% confidence interval, 0.90-0.95)for patients who underwent ischemic evaluation, compared with patients who did not.An ischemic evaluation was associated with lower hazards ratio in males than females: 0.87 (0.84-0.90) vs. 0.98 (0.94-1.02), and in middle-aged vs. older or younger individuals: 0.91 (0.75-1.12) in patients ≤50 years, 0.82 (0.72-0.93) in 51-60 years, 0.83 (0.79-0.87) in 61-75 years, 0.93 (0.88-0.97) in >75-85 years, and 1.02 (0.97-1.07) in >85 years, respectively.Conclusions: Obtaining an ischemic evaluation was associated with marginal to no improvement in long-term mortality for many new-diagnosed heart failure patients, including the very elderly.
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Manivannan et al. (2026) conducted an observational in New-onset heart failure (n=61,475). Ischemic evaluation vs. No ischemic evaluation was evaluated on Long-term all-cause mortality (HR 0.92, 95% CI 0.90-0.95). An ischemic evaluation within 90 days of new-onset heart failure diagnosis was associated with a marginal reduction in long-term mortality (HR 0.92), with limited to no benefit observed in females and the elderly.
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