Approximately 3 million people in the US suffer from heart failure with reduced ejection fraction (HFrEF)1,2

Nearly 1 in 6 patients with HFrEF will worsen to symptomatic heart failure within 1.5 years after initial diagnosis.

This may lead to recurrent hospitalizations.3

Patient progression of symptomatic chronic HFrEF3-6*

Survival probability steadily decreases over time following each worsening heart failure event3

Worsening heart failure is characterized by worsening signs and symptoms of general heart failure, associated with a decline in contractility that can lead to gradually worsening ventricular functioning.7
While GDMT is known to reduce all-cause mortality, recurrent hospitalizations still happen.3,7 Addressing cardiac contractility in treatment may be a viable option.

Heart failure rehospitalizations increase risk for all-cause mortality9

  • In the US alone, >1 million hospitalizations occur annually for heart failure, with approximately half of these patients readmitted within 6 months of discharge. Nearly 30% of these patients die within one year3
  • Heart failure is the most frequent cause of hospitalization in people ≥65 years10

Left ventricular ejection fraction (LVEF) is an important prognostic factor when examining patients with worsening heart failure

  • HFrEF is defined as LVEF ≤40% by 2022 AHA/ACC/HFSA heart failure guidelines7

In addition to the use of LVEF, consider the value of NT-proBNP

With it you can7,12:
  • Aid the diagnosis for heart failure
  • Determine heart failure risk stratification
  • Establish prognosis at hospital discharge

Patients with heart failure who present declining ejection fractions and elevated NT-proBNP levels are at greater risk for an event12,13

Reduced LVEF and elevated NT-proBNP are associated with reduced contractility in HFrEF patients, and research findings suggest that improving LVEF and NT-proBNP can reduce hospitalizations.14,15
  • The estimated total cost of healthcare (indirect and direct) due to heart failure is ~$44 billion in the US, with the annual costs projected to increase to ~$70 billion by 2030 without improvements in outcomes16
  • HF-specific hospitalization costs over 1 year average at $20,000 per patient16
  • Hospitalizations may be a source of distress and could potentially worsen anxiety or depression, contributing to a decrease in QoL17
Patients who have experienced a worsening heart failure event reported greater treatment burden and reduced QoL.18§
*Based on an integrated database analysis from 2010-2016.

Proportion of patients with cardiovascular death or heart failure hospitalization is aggregate data from the CHARM Program (CHARM-Alternative, CHARM-Added, and CHARM-Preserved pivotal trials) evaluating the efficacy and safety of candesartan in patients with New York Heart Association Class II to IV heart failure.2 Because the CHARM Program predates newer therapies for the treatment of HFrEF (eg, SGLT2i, ARNi), current rates for cardiovascular death or heart failure hospitalization may vary.

Adjusted hazard ratio per 100 patient-years for each 10% reduction in LVEF <45% is 1.21 (95% CI, 1.15-1.28).
§Results from recent bivariate analyses.

ACC, American College of Cardiology; AHA, American Heart Association; ARNi, angiotensin receptor neprilysin inhibitor; CHARM, Candesartan in Heart failure: Assessment of Reduction in Mortality; EF, ejection fraction; GDMT, guideline-directed medical therapy; HF, heart failure; HFSA, Heart Failure Society of America; NT-proBNP, N-terminal pro-brain natriuretic peptide; QoL, quality of life; SGLT2i, Sodium/glucose cotransporter-2 inhibitors.

References: 1. Fonarow GC et al. J Am Coll Cardiol. 2007;50(8):768-777. 2. Tsao CW et al. Circ. 2022;145:e153–e639. 3. Butler J et al. J Am Coll Cardiol. 2019;73(8):935-944. 4. Gheorghiade M et al. Am J Cardiol. 2005;96(6A):11G-17G. 5. Greene et al. Eur J Heart Fail. 2019;21(1)121-124. 6. Malik A et al. Am J Med. 2020;133(1):84-94. 7. Heidenreich PA et al. J Am Coll Cardiol. 2022;79(17):e263-e421. 8. Chang PP et al. Am J Cardiol. 2014;113(3):504-510. 9. Setoguchi S et al. Am Heart J. 2007;154(2):260-266. 10. Rethy L et al. 2020;13(11):e007014. 11. Solomon SD et al. Circ. 2005;112(24):3738-3744. 12. Rørth R et al. Circ Heart Fail. 2020;13(2):e006541. 13. Okuhara Y et al. Sci Rep. 2019;9(1):17271. 14. Ito S et al. JACC Cardiovasc Imaging. 2020;13(2):357-369. 15. Huusko J et al. ESC Heart Failure. 2020;7:2406–2417. 16. Urbich M et al. PharmacoEconomics. 2020;38(11):1219-1236. 17. de Almeida FA et al. Health Qual Life Outcomes. 2020;18(262):1-10. 18. Dunbar SB et al. J Card Fail. 2021;27(8):877-887.