Heart failure & cardiomyopathies
Worse long-term outcomes in new-onset HF with preserved EF (HFpEF) vs HFrEF and HFmrEF: findings from the Stockholm PREFERS study
Authors' conclusion
In new-onset HF managed in university hospital-based HF clinics, HFpEF had worse long-term outcomes than HFmrEF and HFrEF combined. The findings highlight the severity of HFpEF and the need for more effective treatment strategies.
Study context
- Population
- Patients with new-onset heart failure treated in heart failure (HF) clinics, by ejection fraction categoryenrolled between 2015 and 2019 · HFpEF 135 · HFmrEF 61 · HFrEF 351
- Participants
- 547 patients
- Exposure
- HFpEF vs HFmrEF/HFrEF
- HFpEFn = 135
- HFmrEFn = 61
- HFrEFn = 351
- Outcome
- Time to cardiovascular (CV) mortality or first HF hospitalization (HFH)
- Follow-up
- Median 3.8 years (IQR 3.0-4.7)
Methodological detailsprospective
- Prospective
Main finding
As reported in the abstract
Time to cardiovascular (CV) mortality or first HF hospitalization (HFH)
Each group vs HFmrEF/HFrEFEstimate (95% CI)P value
HFpEF
unadjusted HR 2.2(1.5–3.1)
P < 0.001HFpEF
adjusted HR 1.7(1.1–2.9)
P < 0.05Observational data: associations, not effects.
Secondary outcomes
| Outcome | HFpEF | HFmrEF | HFrEF | HFmrEF/HFrEF | |
|---|---|---|---|---|---|
| Baseline characteristics | |||||
| Mean age | 76 | 71 | 67 | Not reported in the abstract | HFmrEF/HFrEF: not reported in the abstract |
| Median EF | 55% | 45% | 30% | Not reported in the abstract | HFmrEF/HFrEF: not reported in the abstract |
| Change in NT-proBNP and EF · 1 year | |||||
| NT-proBNP decrease | Not reported in the abstract | 42% (P < .05) | 55% (P < .001) | Not reported in the abstract | HFpEF, HFmrEF/HFrEF: not reported in the abstract |
| EF increase | Not reported in the abstract | 2% points (pp) (P < .05) | 16 pp (P < .001) | Not reported in the abstract | HFpEF, HFmrEF/HFrEF: not reported in the abstract |
| EF decrease | 5 pp (P < .001) | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | HFmrEF, HFrEF, HFmrEF/HFrEF: not reported in the abstract |
| NT-proBNP | no change | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | HFmrEF, HFrEF, HFmrEF/HFrEF: not reported in the abstract |
- Baseline characteristics: all P < .001 across groups
Overall event rates
- All-cause mortality
- 12.8%
- Cardiovascular (CV) mortality
- 9.1%
- HF hospitalization (HFH)
- 12.3%
Original publication
Worse long-term outcomes in new-onset HFpEF vs HFrEF and HFmrEF: findings from the Stockholm PREFERS study. ESC Heart Fail. Published 9 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it