Heart failure & cardiomyopathiesResearch article
Frailty Status Predicts Adverse Outcomes in Ambulatory Heart Failure With Preserved Ejection Fraction
- Ambulatory Heart Failure with Preserved Ejection Fraction (HFpEF) patients referred to the Johns Hopkins HFpEF Clinic
Authors' conclusion
Frailty is common in ambulatory HFpEF. In unadjusted models, frailty is associated with higher risk, but this is attenuated after accounting for congestion and anemia/iron markers, supporting a shared pathophysiologic pathway linking frailty and HFpEF.
Study context
- Population
- Ambulatory patients with heart failure with preserved ejection fraction (HFpEF) referred to the Johns Hopkins HFpEF Clinicage 65 ± 11 years, 66% women
- Participants
- 184 patients
- Comparison
- frail vs nonfrail/prefrail patients
- frailn = 75
- Outcome
- HF-related hospitalization or death
- Follow-up
- Through 3 years
Main finding
As reported in the abstract
frail vs nonfrail/prefrailHazard ratio (95% CI)P value
HF-related hospitalization or death
1.60(1.05–2.44)
P = 0.028men
2.49(1.15–5.39)
women
1.32(0.79–2.19)
adjusted for PCWP
1.58(0.92–2.72)
P = 0.100adjusted for hemoglobin and ferritin
1.08(0.65–1.78)
P = 0.763- composite events over 3 years
- 87
Further findings
Correlates of frailty
- Frail patients had worse functional class, higher N-terminal pro B-type natriuretic peptide, higher ferritin, lower hemoglobin, higher pulmonary capillary wedge pressure (PCWP), and greater endomyocardial biopsy inflammatory infiltrate
- Age and PCWP correlated with higher frailty scores
Original publication
Frailty Status Predicts Adverse Outcomes in Ambulatory Heart Failure With Preserved Ejection Fraction. JACC Adv. Published 26 February 2026. doi:10.1016/j.jacadv.2025.102560
Summarised from the published abstract; every number is checked against it