Combined Prognostic Value of Follow‐Up Ejection Fraction and Natriuretic Peptide Measurements in Heart Failure With Reduced Ejection Fraction Following Initiation of Pharmacotherapy

Journal of the American Heart Association, Volume 15, Issue 11 , June 2, 2026. BackgroundFew studies have directly compared the prognostic value of left ventricular ejection fraction (LVEF) and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) in patients with heart failure (HF) with reduced EF who have initiated guideline‐directed medical therapy.

This study sought to assess the combined prognostic value of follow‐up LVEF and NT‐proBNP measurements taken following initiation of guideline‐directed medical therapy in patients with HF with reduced EF.MethodsThis retrospective cohort study (2009–2024) conducted at a large, integrated health system included 6168 patients who had a diagnosis of HF with reduced EF (LVEF ≤40%) along with available LVEF and NT‐proBNP measurements at ~9 months following diagnosis, which was defined as the study baseline. A composite outcome of HF hospitalization or all‐cause death was assessed.ResultsA large majority of patients were on at least 2 guideline‐directed medical therapy medications at baseline.

The median LVEF was 36% (interquartile range, 27–46), and the median NT‐proBNP was 2161 pg/mL (interquartile range, 610–7350).