Heart failure & cardiomyopathiesSecondary analysis
Predicted versus observed outcomes in the ALT-FLOW early feasibility study
- post hoc analysis
- early feasibility study
Authors' conclusion
In ALT-FLOW EFS, observed 1-year mortality was lower than MAGGIC-predicted mortality, and post implantation HFH rates were lower than pre implantation rates. These hypothesis-generating findings will require confirmation in the randomized, sham-controlled ALT-FLOW II trial.
Study context
- Population
- Patients with heart failure with left ventricular ejection fraction >40% undergoing APTURE left atrial-to-coronary sinus shunt implantation in ALT-FLOW EFSpatients undergoing APTURE implantation
- Participants
- 95 patients
- Comparison
- Observed vs MAGGIC-predicted
Primary result
As reported in the abstract
1-year survival, observed vs MAGGIC-predicted · 1 year
P = 0.04
- MAGGIC-predicted 1-year mortality
- 13.0%
Further findings
| Outcome | Values | P value |
|---|---|---|
| Proportion of patients with HFH · 12 months before vs after implantation · declined post implantation | Pre implantation 37.9% · Post implantation 9.6% | P < 0.0001 |
| HFH event rate · falling post implantation | Pre implantation 0.61 per patient-year · Post implantation 0.21 per patient-year | P < 0.001 |
Cumulative hazard of recurrent heart failure hospitalization (HFH) · 1 year
- 1-year cumulative hazard of recurrent HFH
- 0.19 (95% confidence interval, 0.12-0.31)
Baseline characteristics
- mean age
- 70.9 ± 8.5 years
- women
- 50%
- New York Heart Association Class III
- 93%
- H2FPEF score >3
- 85.9%
HFH by NT-proBNP strata
- HFHs were evenly distributed across NT-proBNP strata
Original publication
Predicted versus observed outcomes in the ALT-FLOW early feasibility study. ESC Heart Fail. Published 8 June 2026. doi:10.1093/eschf/xvag101
Summarised from the published abstract; every number is checked against it