Heart failure & cardiomyopathiesSecondary analysis
Expanded Definition of Worsening Heart Failure
- Secondary analysis of the REDUCE LAP-HF II randomised trial
Authors' conclusion
An expanded definition of WHF more clearly identified the treatment effect of an atrial shunt in a responder group and the negative association of WHF with change in quality of life.
Study context
- Population
- Patients with HF in the REDUCE LAP-HF II trial
- Participants
- 621 patients
- Comparison
- Atrial shunt vs sham control procedure
- Primary endpoint
- Associations of an expanded WHF definition (level 1: hospitalization requiring IV diuretics; level 2: urgent outpatient encounters with diuretic intensification; level 3: nonurgent encounters with augmentation of oral diuretics) with treatment effect, mortality and change in KCCQ-Overall Summary Score
- Follow-up
- 24 months
Primary result
WHF events by level
Hazard ratio
3.54
95% CI 1.83–6.87
P = 0.0002
Level 1 WHF vs Sham control
HR 3.54 (95% CI 1.83–6.87); P = 0.0002
As reported in the abstract
- ≥1 worsening heart failure (WHF) event
- 161 (25.9%)
- Any level 1 WHF event
- 108 (17.4%)
- Level 2 WHF event
- 22 (3.5%)
- Only level 3 WHF events
- 31 (5.0%)
Original publication
Expanded Definition of Worsening Heart Failure. JACC Heart Fail. Published 25 July 2025. doi:10.1016/j.jchf.2025.102571
Summarised from the published abstract; every number is checked against it