Heart failure & cardiomyopathiesSecondary analysis
The efficacy and safety of qiliqiangxin according to baseline ejection fraction in patients with heart failure and reduced ejection fraction in QUEST
- Secondary analysis of the QUEST randomised trial
- post hoc analysis
Authors' conclusion
In patients with HFrEF, lower LVEF was associated with worse cardiovascular outcomes. QLQX reduced cardiovascular events consistently across the range of LVEF examined in QUEST, despite the limited use of sodium-glucose co-transporter 2 inhibitors.
Study context
- Population
- Patients with symptomatic heart failure (HF) and left ventricular ejection fraction (LVEF) ≤40% (heart failure and reduced ejection fraction (HFrEF))
- Participants
- 3,110 patients
- Comparison
- QLQX vs control, by baseline LVEF
- LVEF ≤25%n = 482
- LVEF >25-30%n = 692
- LVEF >30-35%n = 829
- LVEF >35%n = 1,107
- Primary endpoint
- CV death or first HF hospitalization
Primary result
As reported in the abstract
CV death or first HF hospitalization, by baseline LVEF category (subgroup analysis)
QLQXHazard ratio (95% CI)
LVEF ≤25%
0.91(0.64–1.30)
LVEF >25-30%
0.65(0.47–0.89)
LVEF >30-35%
0.94(0.71–1.26)
LVEF >35%
0.71(0.55–0.91)
- Effect of QLQX consistent across LVEF categories
- P for interaction = 0.28
- Effect of QLQX consistent with LVEF as a continuous variable
- P for interaction = 0.45
Further findings
| Outcome | LVEF ≤25% | LVEF >25-30% | LVEF >30-35% | LVEF >35% |
|---|---|---|---|---|
| Primary outcome rate by baseline LVEF | 25.4 per 100 patient-years | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract |
- Primary outcome rate by baseline LVEF — Similar rates across higher LVEF groups
- 18.7-19.8
Primary outcome rate by baseline LVEF
- Lower LVEF independently associated with higher risk of primary outcome and mortality after multivariable adjustment
Individual components and total HF hospitalizations, by LVEF
- Similar results across LVEF categories
- all interaction P > .10
Safety
Safety of QLQX by LVEF
- Safety of QLQX consistent across LVEF categories
Original publication
The efficacy and safety of qiliqiangxin according to baseline ejection fraction in patients with heart failure and reduced ejection fraction in QUEST. Eur J Heart Fail. Published 12 January 2026. doi:10.1093/ejhf/xuaf017
Summarised from the published abstract; every number is checked against it