Heart failure & cardiomyopathiesCohort study

Worse long-term outcomes in new-onset HF with preserved EF (HFpEF) vs HFrEF and HFmrEF: findings from the Stockholm PREFERS study

ESC Heart FailPublished

  • Stockholm PREFERS study
  • prospective

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)

Main finding

As reported in the abstract

Each group vs HFmrEF/HFrEFEstimate (95% CI)P value
HFpEF
unadjusted HR 2.2(1.5–3.1)
P < 0.001
HFpEF
adjusted HR 1.7(1.1–2.9)
P < 0.05

Observational data: associations, not effects.

Secondary outcomes

OutcomeHFpEFHFmrEFHFrEFHFmrEF/HFrEF
Baseline characteristics
mean age767167Not reported in the abstract
median EF55%45%30%Not reported in the abstract
Change in NT-proBNP and EF · 1 year
NT-proBNP decreaseNot reported in the abstract42% (P < .05)55% (P < .001)Not reported in the abstract
EF increaseNot reported in the abstract2% points (pp) (P < .05)16 pp (P < .001)Not reported in the abstract
EF decrease5 pp (P < .001)Not reported in the abstractNot reported in the abstractNot reported in the abstract
NT-proBNPno changeNot reported in the abstractNot reported in the abstractNot 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:10.1093/eschf/xvag105

Summarised from the published abstract; every number is checked against it