Heart failure & cardiomyopathies

Lactate Dehydrogenase and Outcomes in Patients With Heart Failure (HF) and Reduced Ejection Fraction: Insights From GALACTIC-HF

JACC Heart FailPublished Secondary analysis of the GALACTIC-HF randomised trial

Authors' conclusion

In GALACTIC-HF, higher LDH levels were independently associated with a higher risk of clinical outcomes in HFrEF.

Study context

Population
Patients with heart failure and reduced ejection fraction (HFrEF) in GALACTIC-HF (omecamtiv mecarbil vs placebo) with baseline lactate dehydrogenase (LDH)6,138 outpatients
Participants
8,179 patients
Comparison
LDH quartiles
Primary endpoint
First HF event or CV death
Methodological detailsphase 3, placebo-controlled
  • Phase 3
  • Placebo-controlled

Primary result

As reported in the abstract

Each group vs Q1Hazard ratio (95% CI)
Q2
1.15(1.02–1.31)
Q3
1.39(1.23–1.58)
Q4
1.84(1.62–2.08)

Further findings

Incremental prognostic value over PREDICT-HF model

Baseline LDH improved Harrell's C statistic, integrated discrimination index (IDI) and net reclassification index (NRI) for the primary outcome

Baseline characteristics by LDH

Higher LDH: more often female, worse HF status, higher creatinine, liver enzymes, creatine kinase, NT-proBNP and hs-troponin I

Original publication

Lactate Dehydrogenase and Outcomes in Patients With HF and Reduced Ejection Fraction: Insights From GALACTIC-HF. JACC Heart Fail. Published 13 January 2026. doi:10.1016/j.jchf.2025.102900

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