Key result
Among ambulatory heart failure patients with LVEF < 50%, 3-year all-cause mortality progressively declined from 30.5% in 2001-2004 to 17.0% in 2015-2018, whereas no significant trend was observed in those with preserved LVEF.
Why the study?
The study was conducted to assess 1- and 3-year mortality trends from 2001 to 2018 in a real-life cohort of HF outpatients with depressed and preserved LVEF.
Cohort (n=2,368)
No
Absolute Event Rate: 17% vs 30.5%
Absolute Risk Reduction: 13.5%
p-value: p=0.003
Over a 19-year period, mortality rates significantly declined in ambulatory heart failure patients with reduced ejection fraction, but not in those with preserved ejection fraction, highlighting the ongoing therapeutic gap in HFpEF.
HF mortality improved only in reduced EF; extends evidence of uneven therapeutic gains and leaves open HFpEF-specific strategies.
To assess mortality trends at 1 and 3 years from 2001 to 2018 in a real-life cohort of HF outpatients from different etiologies with depressed and preserved LVEF. A total of 2368 consecutive patients with HF (mean age 66.4 ± 12.9 years, 71% men, 15.4% with preserved LVEF) admitted to a HF clinic from August 2001 to September 2018 were included in the study. Patients were divided into five quintiles (Q) according to the period of admission. Trends for all-cause and cardiovascular mortality from Q1 to Q5 were assessed by linear regression. Patients with LVEF < 50% had a progressive decrease in the rates of all-cause and cardiovascular death at 1 year (12.1% in Q1 to 6.5% in Q5, p = 0.003; and 8.4% in Q1 to 3.8% in Q5, p = 0.007, respectively) and 3 years (30.5% in Q1 to 17.0% in Q5, p = 0.003; and 23.9% in Q1 to 9.8% in Q5, p = 0.003, respectively). These trends remained significant after adjusting for clinical characteristics and risk. No significant trend in mortality was observed in patients with LVEF ≥ 50%. In a cohort of real-life ambulatory patients with HF, mortality progressively declined in patients with LVEF < 50%, but the same trend was not observed in patients with preserved LVEF.
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Spitaleri et al. (2021) conducted a cohort in Heart failure (n=2,368). Later period of admission (2015-2018) vs. Earlier period of admission (2001-2004) was evaluated on 3-year all-cause mortality (LVEF < 50%) (p=0.003). Among ambulatory heart failure patients with LVEF < 50%, 3-year all-cause mortality progressively declined from 30.5% in 2001-2004 to 17.0% in 2015-2018, whereas no significant trend was observed in those with preserved LVEF.
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