Heart failure & cardiomyopathiesMeta-analysis
Surrogate markers of clinical endpoints in clinical trials of heart failure
- Systematic review and meta-analysis of randomised trials
- meta-regression
- random-effects
Authors' conclusion
In HF trials, most surrogate markers, including NPs and echocardiographic measures were only weakly or moderately correlated with treatment effects on all-cause mortality.
Study context
- Population
- Randomized trials of interventions in patients with heart failure (HF) (literature search until October 2024)
- Participants
- 120,304 participants · 96 RCTs
- Comparison
- Treatment-related changes in surrogate markers vs treatment effects on all-cause mortality and HF hospitalization
- Outcome
- Association of treatment-related changes in 15 surrogate markers with all-cause mortality and HF hospitalization (R2, STE)
Pooled result
As reported in the abstract
Natriuretic peptides (NPs) vs all-cause mortality (64 comparisons): weakly correlated, P = .002, STE = −34%
R2 = 12%
NPs vs HF hospitalization (41 comparisons): weakly correlated, P < .001, STE = −30%
R2 = 32%
LVEF vs mortality (69 comparisons): moderately correlated, P < .001, STE = +6%
R2 = 59%
LVEF vs HF hospitalization (45 comparisons): strongly correlated, P < .001, STE = +2%; only in HFrEF trials
R2 = 90%
Original publication
Surrogate markers of clinical endpoints in clinical trials of heart failure. Eur J Heart Fail. Published 6 February 2026. doi:10.1093/ejhf/xuag033
Summarised from the published abstract; every number is checked against it