ArticleJournal of the American College of Cardiology2023
Effect of 2022 ACC/AHA/HFSA Criteria on Stages of Heart Failure in a Pooled Community Cohort.
Article in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Association Between the 2022 AHA/ACC/HFSA Heart Failure Staging and Cardiovascular and Kidney Outcomes in Patients With Diabetes and Kidney Disease: A Post Hoc Analysis of the SCORED Randomized Controlled Trial.Circulation. Heart failure · 2026Trial
- Effects of sacubitril/valsartan on hypertensive heart disease: the REVERSE-LVH randomized phase 2 trial.Nature communications · 2025Trial
- The Intersection of Heart Failure with Preserved Ejection Fraction and CKD.Clinical journal of the American Society of Nephrology : CJASN · 2026Review
- Natriuretic peptides are integral in reclassifying heart failure stage and risk.Heart and vessels · 2026Article
- Refined Heart Failure Stages Incorporating Cardiorespiratory Fitness Are Differentially Associated With Heart Failure Risk in the Community.Journal of the American Heart Association · 2026Observational
- Will Evaluation of Cardiorespiratory Fitness Improve Risk Stratification of Patients With Stage B Heart Failure?Journal of the American Heart Association · 2026Article
- Preclinical Heart Failure: A Dynamic Trajectory of Progression, Regression, and Risk.Journal of the American Heart Association · 2026Article
- Challenges of Classifying Stage B Heart Failure in a High-Risk Population.Journal of cardiovascular development and disease · 2026Article
- A comparative analysis of echocardiographic data for heart transplant eligibility in brain death cases.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Article
- Prognostic value of Short Physical Performance Battery in older patients with Stage B heart failure: a prospective cohort study.BMC geriatrics · 2025Article
- Sleep Quality and Outcomes in Preclinical Heart Failure: A Prospective UK Biobank Cohort Study.The American journal of medicine · 2025Article
- Prevalence of heart failure stages in elderly population: from a community-dwelling elderly people survey.BMC geriatrics · 2025Article
- Natriuretic Peptide Cut Points for Heart Failure Classification in Individuals With and Without Obesity.Circulation. Heart failure · 2025Article
- Application of the American Heart Association/American College of Cardiology/Heart Failure Society of America Heart Failure Staging Guidelines in Adults With Chronic Kidney Disease.Journal of the American Heart Association · 2025Article
- Prevalence and Mortality of Heart Failure Stages in a Free-Living Older Adult Population: Data From the Brazilian Longitudinal Study of Adult Health.Journal of the American Heart Association · 2025Article
- Baseline characteristics and 1-year outcome by left ventricular function in the CABG PREFERS.European heart journal open · 2025Article
- Left Atrial Function and Incident Heart Failure in Older Adults.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2025Article
- Comparison and identification of serum metabolomic profiles in Stage B and Stage C ejection fraction preserved heart failure.Frontiers in cardiovascular medicine · 2025Article
- Implications of Preoperative C-Reactive Protein Levels in Heart Transplant Patients-A Single-Center Retrospective Study.Journal of clinical medicine · 2024Article
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2023
Authors and funding
13 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundThe 2022 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) clinical practice guideline proposed an updated definition for heart failure (HF) stages.
objectivesThis study aimed to compare prevalence and prognosis of HF stages according to classification/definition originally described in 2013 and 2022 ACC/AHA/HFSA definitions.
methodsStudy participants from 3 longitudinal cohorts (the MESA [Multi-Ethnic Study of Atherosclerosis], CHS [Cardiovascular Health Study], and the FHS [Framingham Heart Study]), were categorized into 4 HF stages according to the 2013 and 2022 criteria. Cox proportional hazards regression was used to assess predictors of progression to symptomatic HF and adverse clinical outcomes associated with each HF stage.
resultsAmong 11,618 study participants, according to the 2022 staging, 1,943 (16.7%) were healthy, 4,348 (37.4%) were in stage A (at risk), 5,019 (43.2%) were in stage B (pre-HF), and 308 (2.7%) were in stage C/D (symptomatic HF). Compared to the classification/definition originally described in 2013, the 2022 ACC/AHA/HFSA approach resulted in a higher proportion of individuals with stage B HF (increase from 15.9% to 43.2%); this shift disproportionately involved women as well as Hispanic and Black individuals. Despite the 2022 criteria designating a greater proportion of individuals as stage B, the relative risk of progression to symptomatic HF remained similar (HR: 10.61; 95% CI: 9.00-12.51; P < 0.001).
conclusionsNew standards for HF staging resulted in a substantial shift of community-based individuals from stage A to stage B. Those with stage B HF in the new system were at high risk for progression to symptomatic HF.
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