Heart failure & cardiomyopathies
Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure With Improved Ejection Fraction
Authors' conclusion
A significant percentage of patients with HFrEF experience improvement in ejection fraction, transitioning to HFimpEF, yet remain at significant clinical risk.
Study context
- Population
- Patients with incident Heart Failure with Reduced Ejection Fraction (HFrEF), Kaiser Permanente Northern California, January 2013–December 2022
- Participants
- 28,292 patients
- Exposure
- Heart failure with improved ejection fraction (HFimpEF) vs persistent HFrEF
- HFimpEFn = 8,656
- Outcome
- Worsening HF and death
Methodological detailsmultisite integrated health care delivery system
- Multisite integrated health care delivery system
Main finding
As reported in the abstract
HFimpEF
- Worsening HF
- 17.4 per 100 person-years (95% CI: 16.9-18.0)
- Death
- 5.7 per 100 person-years (95% CI: 5.4-6.0)
Persistent HFrEF
- Worsening HF
- 34.1 per 100 person-years (95% CI: 33.5-34.6)
- Death
- 11.0 per 100 person-years (95% CI: 10.7-11.3)
Worsening HF
HFimpEF17.4 per 100 person-years (95% CI: 16.9-18.0)
Persistent HFrEF34.1 per 100 person-years (95% CI: 33.5-34.6)
Death
HFimpEF5.7 per 100 person-years (95% CI: 5.4-6.0)
Persistent HFrEF11.0 per 100 person-years (95% CI: 10.7-11.3)
HFimpEF vs Persistent HFrEFHazard ratio (95% CI)
Worsening HF
0.58(0.55–0.61)
Death
0.52(0.49–0.56)
Observational data: associations, not effects.
Further findings
- Incidence of HFimpEF within 12 months
- 30.6% · 8,656
Guideline-directed medical therapy (GDMT) use after incident HFimpEF
- Use of GDMT marginally decreased in most medication categories after incident HFimpEF
GDMT withdrawal
- Withdrawal of GDMT modestly associated with greater clinical risk
Original publication
Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure With Improved Ejection Fraction. J Am Coll Cardiol. Published 5 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →