Incidence and Outcomes of Acute Heart Failure With Preserved Versus Reduced Ejection Fraction in SPRINT
Year: 2021
Type: article
Abstract: BACKGROUND: In the SPRINT (Systolic Blood Pressure Intervention Trial), intensive BP treatment reduced acute decompensated heart failure (ADHF) events. Here, we report the effect on HF with preserved ejection fraction (HFpEF) and HF with reduced EF (HFrEF) and their subsequent outcomes. METHODS: Incident ADHF was defined as hospitalization or emergency department visit, confirmed, and formally adjudicated by a blinded events committee using standardized protocols. HFpEF was defined as EF ≥45%, and HFrEF was EF <45%. RESULTS: value: 0.73). During average 3.3 years follow-up in those who developed incident ADHF, rates of subsequent all-cause and HF hospital readmission and mortality were high, but there were no significant differences between those who developed HFpEF versus HFrEF. Randomization to the intensive arm had no effect on subsequent mortality or readmissions after the initial ADHF event, irrespective of EF subtype. During follow-up among participants who developed HFpEF, although relatively modest number of events limited statistical power, age was an independent predictor of all-cause mortality, and Black race independently predicted all-cause and HF hospital readmission. CONCLUSIONS: In SPRINT, intensive BP reduction decreased both acute decompensated HFpEF and HFrEF events. After initial incident ADHF, rates of subsequent hospital admission and mortality were high and were similar for those who developed HFpEF or HFrEF. Randomization to the intensive arm did not alter the risks for subsequent all-cause, or HF events in either HFpEF or HFrEF. Among those who developed HFpEF, age and Black race were independent predictors of clinical outcomes. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062.
Source: Circulation Heart Failure
Authors: Bharathi Upadhya, James J. Willard, Laura C. Lovato, Michael V. Rocco, Cora E. Lewis, Suzanne Oparil, William C. Cushman, Jeffrey T. Bates, Natalie A. Bello, Gerard Aurigemma, Karen C. Johnson, Carlos J. Rodriguez, Dominic S. Raj, Anjay Rastogi, Leonardo Tamariz, Alan Wiggers, Dalane W. Kitzman
Institutions: Wake Forest University Health Sciences, Wake Forest University, University of Alabama at Birmingham, UAB Medicine, University of Tennessee Health Science Center, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Columbia University Irving Medical Center, Columbia University, University of Massachusetts Chan Medical School, Albert Einstein College of Medicine, George Washington University, University of California, Los Angeles, University of Miami, Veterans Health Administration, Miami VA Healthcare System, University Hospitals of Cleveland, University Hospitals Cleveland Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Veterans Affairs, GlaxoSmithKline, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: Stanford Center for Clinical and Translational Education and Research (SCCTER)UL1, G1153142239, G1201304535, G130883262, G1346455397, G1452718737, G1513832538, G1534123016, G1575401839, G1815451664, G2244966566, The Ohio State University Center for Clinical and Translational Science (UL1), Tufts Clinical and Translational Research Institute, Stanford Center for Clinical & Translational Education and Research (Spectrum), G3042542605, Translational Research in Hypertension and Renal Biology, UC Davis Clinical and Translational Science Center, G3759862710, Clinical and Translational Science Institute at Children's National, UF Clinical and Translational Science Award, Exercise Intolerance in Older HFPEF Patients, G5068655555, G522538789, Institutional Clinical and Translational Science Award, G576625284, G5831220822, Tufts Clinical and Translation Science Institute (UL1), G5971433106, G641036678, G7249625361, G742032275, Institutional Clinical and Translational Science Award, The Vanderbilt Institute for Clinical and Translational Research (VICTR), Clinical and Translational Science Collaborative of Cleveland, G863154122, G8723760441, Clinical and Translational Science Collaborative of Cleveland, G8798524273, G884570035, G9000048077
OpenAlex ID: W3215397072