Heart failure & cardiomyopathiesRandomised controlled trial
Lifetime benefits of comprehensive medical therapy in heart failure with mildly reduced or preserved ejection fraction
- Cross-trial analysis of the DELIVER, FINEARTS-HF and PARAGON-HF randomised trials
Authors' conclusion
Among patients with HFmrEF and HFpEF, the potential aggregated long-term treatment effects of early combination medical therapy with SGLT2i and nsMRA (and ARNI in selected individuals) are projected to be substantial.
Study context
- Population
- Patients with HFmrEF/HFpEF
- Comparison
- Combined SGLT2i + nonsteroidal mineralocorticoid receptor antagonist (nsMRA) therapy vs no combined therapy
- Primary endpoint
- CV death or first worsening HF event
Primary result
As reported in the abstract
Hazard ratio (95% CI)
SGLT2i + nsMRAoverall population; estimated 31% risk reduction
0.69(0.59–0.81)
SGLT2i + nsMRA + ARNILVEF <60%; estimated 39% risk reduction
0.61(0.48–0.77)
Further findings
Projected additional years free from CV death or HF event, 65-year-old patient, long-term use
- Projected additional years free from CV death or HF event, 65-year-old patient, long-term use: Angiotensin receptor neprilysin inhibitor (ARNI) combination in patients with left ventricular ejection fraction (LVEF) <60%
Projected additional years free from CV death or HF event, 65-year-old patient, long-term use
- Meaningful gains in event-free survival across ages 55 to 85 years
Original publication
Lifetime benefits of comprehensive medical therapy in heart failure with mildly reduced or preserved ejection fraction. Nat Med. Published 6 October 2025. doi:10.1038/s41591-025-04037-3
Summarised from the published abstract; every number is checked against it