Clinical Report: Trajectories of Biomarkers, Functional Status, and Quality of Life Prior to Death in Heart Failure
Overview
This post hoc analysis of the FINEARTS-HF trial investigates the temporal patterns of biomarkers, functional status, and quality of life in heart failure patients prior to sudden death. Findings indicate that changes in these parameters may not be distinct for sudden death compared to other modes of death.
Background
Heart failure with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) remains a significant cause of cardiovascular mortality. Sudden death accounts for a substantial proportion of deaths in HFpEF, yet current guidelines lack effective risk stratification tools. Understanding the clinical and biological changes preceding sudden death could enhance risk prediction and prevention strategies.
Data Highlights
No numerical data available in the source material.
Key Findings
Sudden death in HFpEF is often preceded by modest worsening in functional status and symptom burden.
Changes in NT-proBNP levels were assessed alongside functional status and quality of life metrics.
Patterns preceding sudden death overlap with those observed before other modes of death.
Current guidelines do not recommend ICDs for primary prevention in HFpEF due to insufficient evidence.
Identifying distinct trajectories may refine risk prediction for patients at high near-term risk.
Clinical Implications
Clinicians should be aware that the trajectories of biomarkers and functional status may not uniquely identify patients at risk for sudden death. This highlights the need for improved risk stratification methods in managing patients with HFpEF.
Conclusion
The study emphasizes the importance of understanding the clinical course preceding sudden death in heart failure, which may inform future risk assessment strategies.
by Henri Lu, Annamaria Kosztin, Brian L. Claggett, Alberto Foà, Maria A. Pabón, Akshay S. Desai, Pardeep S. Jhund, Alasdair D. Henderson, Bela Merkely, Carolyn S. P. Lam, Michele Senni, Sanjiv J. Shah, Adriaan A. Voors, Faiez Zannad, Bertram Pitt, Flaviana Amarante, Riitta Saarinen, Yoriko De Sanctis, Andrea Glasauer, John J. V. McMurray, Muthiah Vaduganathan, Scott D. Solomon
A prespecified exploratory analysis of the FIND-CKD clinical trial examined kidney function, albuminuria, and kidney failure outcomes in 903 patients with glomerular diseases.
