Approximately 2.85 million people in the US suffer from heart failure with reduced ejection fraction(HFrEF)1

Nearly 1 in 5 patients with HFrEF progress to worsening heart failure* within 1.5 years after initial diagnosis2​

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 gradually deteriorating ventricular dysfunction.4

Each subsequent hospitalization for heart failure increases a patient's risk for all-cause mortality6

  • 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 years7
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 outcomes8

Left ventricular ejection fraction (LVEF) is an important prognostic factor used to classify the severity of patients with worsening heart failure

  • HFrEF is defined as LVEF ≤40% by 2022 AHA/ACC/HFSA heart failure guidelines4

Patients with heart failure who present declining ejection fractions and elevated NT-proBNP levels are at greater risk for an event9,10

In addition to LVEF, consider the value of NT-proBNP. With it, you can4,9:

  • Diagnose heart failure
  • Determine heart failure risk stratification
  • Establish prognosis at hospital discharge

Patients with worsening heart failure often have multiple comorbidities, making SOC optimization a challenge12

  • Most patients with HFrEF typically have ≥3 comorbidities that require treatment13
  • Often, patients with heart failure do not reach optimal SOC doses due to tolerability issues3,14,15§
  • More than half of heart failure patients age ≥65 years are receiving ≥10 medications following an event16

Many comorbidities accompany heart failure17

Adapted from Khan MS et al. Eur J Heart Fail. 2020.

A recent study found that, in patients with worsening heart failure, treatment with SOC remained suboptimal even 6 months after an acute HF event3

In an observational cohort analysis, the use of beta-blockers decreased (69.7% of patients were receiving them 3 months prior to a worsening HF event, to 69.1% 6 months after the event) and ACEi/ARB (46.5% to 46.0%) likewise decreased. Use of MRA therapy remained consistently low (21.8% to 24.7%) across the study.

Patients who have experienced a worsening heart failure event reported greater treatment burden and reduced quality of life

*Worsening heart failure was characterized by worsening signs/symptoms of heart failure or hospitalization from heart failure.

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).

§SOC may include a RAAS inhibitor (ARNi, ACEi, ARB), Beta Blocker, MRA, SGLT2 inhibitor, and/or other medication.

Results from recent bivariate analyses.

ACC, American College of Cardiology; AHA, American Heart Association; EF, ejection fraction; HFSA, Heart Failure Society of America; HFrEF, heart failure with reduced ejection fraction; LVEF, left ventricular ejection fraction; NT-proBNP, N-terminal pro-brain natriuretic peptide; SOC, standard of care.

References: 1. Chahine J. In: StatPearls. StatPearls Publishing; 2022. 2. Dunbar SB et al. J Card Fail. 2021;27(8):877-887. 3. Butler J et al. J Am Coll Cardiol. 2019;73(8):935-944. 4. Heidenreich PA et al. J Am Coll Cardiol. 2022;79(17):e2-e159. 5. Chang PP et al. Am J Cardiol. 2014;113(3):504-510. 6. Chun S et al. Circ Heart Fail. 2012;5(4):414-421. 7. Rethy L et al. 2020;13(11):e007014. 8. Urbich M et al. PharmacoEconomics. 2020;38(11):1219-1236. 9. Rørth R et al. Circ Heart Fail. 2020;13(2):e006541. 10. Okuhara Y et al. Sci Rep. 2019;9(1):17271. 11. Solomon SD et al. Circulation. 2005;112(24):3738-3744. 12. Rao VN et al. Am J Med. 2021;134(9):1068-1070. 13. Saczynski JS et al. J Am Geriatr Soc. 2013;61(1):26-33. 14. Butzner M et al. Am J Manag Care. 2022;28(3):e113-e120. 15. Fiuzat M et al. J Am Coll Cardiol. 2022;79:504-510. 16. Unlu O et al. Circ Heart Fail. 2020;13(11):e006977. 17. Khan MS et al. Eur J Heart Fail. 2020;22(6):1032-1042.