Heart failure & cardiomyopathiesSecondary analysis
Biomarker, Functional Status, and Quality-of-Life Trajectories Before Modes of Death in Heart Failure
- Secondary analysis of the FINEARTS-HF randomised trial
- post hoc analysis
- global, event-driven trial
Authors' conclusion
Results of this post hoc analysis of the FINEARTS-HF randomized clinical trial reveal that in this contemporary HFmrEF or HFpEF cohort, sudden death was preceded by modest worsening of symptoms, declining quality of life, and rising natriuretic peptide levels, suggesting many of these events may not have been entirely sudden. However, similar deterioration preceding other modes of death suggests limited specificity for sudden death.
Study context
- Population
- Symptomatic HF with LVEF ≥40%, NYHA II–IV and elevated NT-proBNP (heart failure with mildly reduced ejection fraction (HFmrEF) or HF with preserved ejection fraction (HFpEF)), enrolled 2020–2023
- Participants
- 6,001 participants
- Comparison
- Trajectories before sudden death vs before other modes of death and survival
- Sudden deathn = 215
- Primary endpoint
- Longitudinal trajectories of NYHA class, KCCQ-TSS and NT-proBNP preceding sudden death vs survivors and other modes of death
Primary result
As reported in the abstract
Trajectories of NYHA class, KCCQ-TSS and NT-proBNP before death or end of follow-up
| Group | NYHA class (6 months before death) | Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) (6 months before death) | NT-proBNP (6 months before death) | NYHA class (18 months before end of follow-up) | KCCQ-TSS (18 months before end of follow-up) | NT-proBNP (18 months before end of follow-up) |
|---|---|---|---|---|---|---|
| Sudden death | approximately 2.3 to 2.4 | approximately 8-point decline | approximately 1800 to 2000 pg/mL | |||
| Survived | approximately 2.3 to 2.1 | approximately 68 to 77 | approximately 800 to 650 pg/mL |
Original publication
Biomarker, Functional Status, and Quality-of-Life Trajectories Before Modes of Death in Heart Failure. JAMA Cardiol. Published 1 June 2026. doi:10.1001/jamacardio.2026.0682
Summarised from the published abstract; every number is checked against it