Heart failure & cardiomyopathies
NT-proBNP and Clinical Outcomes in Patients With Heart Failure with Reduced Ejection Fraction (HFrEF) According to Atrial Fibrillation: Insights From QUEST
Authors' conclusion
The treatment effect of QLQX on CV events was consistent across the spectrum of baseline NT-proBNP in HFrEF. Baseline NT-proBNP strongly predicted the risk of CV outcomes and mortality, irrespective of AF status. (Qiliqiangxin in Heart Failure: Assessment of Reduction in Mortality [QUEST]; ChiCTR1900021929).
Study context
- Population
- Patients with HFrEF and NT-proBNP ≥450 pg/mLenrolled in QUEST, median follow-up 18 months
- Participants
- 3,110 patients
- Comparison
- QLQX vs placebo according to baseline NT-proBNP; prognostic value of baseline NT-proBNP by atrial fibrillation (AF) status
- Primary endpoint
- Cardiovascular (CV) death or heart failure (HF) hospitalization
- Follow-up
- Median 18 months
Primary result
As reported in the abstract
Estimate (95% CI)
Q4 vs Q1baseline NT-proBNP Q4vs Q1 (prognostic)
adjusted HR 4.03(3.12–5.20)
QLQXvs placebolowest NT-proBNP quartile
HR 1.13(0.73–1.76)
QLQXvs placebosecond NT-proBNP quartile
HR 0.76(0.54–1.06)
QLQXvs placebothird NT-proBNP quartile
HR 0.73(0.55–0.95)
QLQXvs placebohighest NT-proBNP quartile
HR 0.75(0.59–0.95)
Further findings
Prognostic value of baseline NT-proBNP by AF status
- Consistent irrespective of AF status for all outcomes
NT-proBNP · 3 months
- Reduction with QLQX compared with placebo
- 10%
Cardiovascular (CV) death, heart failure (HF) hospitalization, total HF hospitalizations; NT-proBNP modeled continuously
- Results consistent
- all Pinteraction ≥ 0.30
Baseline NT-proBNP
- Median baseline NT-proBNP
- 1,731 pg/mL
Original publication
NT-proBNP and Clinical Outcomes in Patients With HFrEF According to Atrial Fibrillation: Insights From QUEST. JACC Heart Fail. Published 26 October 2026. doi:10.
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