Evidence map›Paper›PMID 41967095›Full record

ArticleESC heart failure2026

Worse long-term outcomes in new-onset HFpEF vs HFrEF and HFmrEF: findings from the Stockholm PREFERS study.

Hans Persson, Anton Winderud, Camilla Hage, Carin Corovic Cabrera, Ulrika Löfström, Patrik Lyngå, Taner Arslan, Karin Knudsen Malmqvist, Maria J Eriksson, Bengt Persson and 3 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03671122 (PREFERS PREFERS), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

NCT03671122 completednot on this map

PREFERS PREFERS (Preserved and Reduced Ejection Fraction Epidemiological Regional Study) Stockholm Heart Failure Study

TypeobservationalSponsorKarolinska InstitutetRan2015 to 2021Enrolled683ConditionsHeart Failure, Diastolic, Heart Failure，CongestiveArmsCardiac imaging in the PREFERS and CABG PREFERS cohorts, Biomarker analysis in the PREFERS and CABG PREFERS chorts, Cardiac biopsies in the CABG PREFERS cohort
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Hans PerssonDepartment of Cardiology, Danderyd Hospital, 182 88 Stockholm, Sweden.
Anton WinderudDepartment of Cardiology, Danderyd Hospital, 182 88 Stockholm, Sweden.
Camilla HageDepartment of Medicine, Karolinska Institutet, Stockholm, Sweden.
Carin Corovic CabreraDepartment of Cardiology, South Hospital, Stockholm, Sweden.
Ulrika LöfströmDepartment of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0009-0009-3972-0172
Patrik LyngåDepartment of Cardiology, South Hospital, Stockholm, Sweden.
Taner ArslanTranslational Science & Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Karin Knudsen MalmqvistDepartment of Cardiology, Danderyd Hospital, 182 88 Stockholm, Sweden.
Maria J ErikssonDepartment of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
Bengt PerssonScience for Life Laboratory, Department of Cell and Molecular Biology, Uppsala University, Uppsala, Sweden.
Håkan WallénDepartment of Cardiology, Danderyd Hospital, 182 88 Stockholm, Sweden.
Mattias EkströmDepartment of Cardiology, Danderyd Hospital, 182 88 Stockholm, Sweden.ORCID 0000-0001-9448-8403
Cecilia LindeDepartment of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-9039-6023

Funding

Danderyd HospitalKarolinska InstitutetScience for Life Laboratory-AstraZeneca and MölndalStiftelsen HjärtatStockholm County CouncilSwedish Heart and Lung FoundationSwedish Research Council 2018-0899Swedish Research Council 2020-01978Uppsala University
6 · The paper itself

Abstract

BACKGROUND AND

aimsProspective outcome data in new-onset heart failure (HF) by ejection fraction (EF) category treated in HF clinics are limited. The Stockholm PREFERS study compared long-term outcomes in new-onset HF with preserved EF (HFpEF), mildly reduced EF (HFmrEF), and reduced EF (HFrEF). METHODS AND

resultsBetween 2015 and 2019, 547 patients were enrolled: HFpEF n = 135 (25%), HFmrEF n = 61 (11%), and HFrEF n = 351 (64%). The mean age was 76, 71, and 67 years for HFpEF, HFmrEF, and HFrEF; the median baseline EF was 55%, 45%, and 30% (all P < .001 across groups). The primary outcome was time to cardiovascular (CV) mortality or first HF hospitalization (HFH). Secondary outcomes were all-cause mortality, CV mortality, and HFH. NT-proBNP and EF were reassessed at 1 year. The median follow-up was 3.8 years (IQR 3.0-4.7). The risk for the primary outcome was higher in HFpEF than in HFmrEF/HFrEF (unadjusted HR 2.2; 95% CI 1.5-3.1; P < .001; adjusted HR 1.7; 95% CI 1.1-2.9; P < .05). Overall event rates were: all-cause mortality 12.8%, CV mortality 9.1%, HFH 12.3%. At 1 year, NT-proBNP decreased in HFmrEF by 42% (P < .05) and in HFrEF by 55% (P < .001), with EF increases of 2% points (pp) (P < .05) and 16 pp (P < .001), respectively. In HFpEF, EF decreased by 5 pp (P < .001) with no change in NT-proBNP.

conclusionsIn new-onset HF managed in university hospital-based HF clinics, HFpEF had worse long-term outcomes than HFmrEF and HFrEF combined. The findings highlight the severity of HFpEF and the need for more effective treatment strategies. CLINICAL TRIAL: NCT03671122.

Indexed as

Heart FailureStroke VolumeAgedCause of DeathFemaleFollow-Up StudiesHospitalizationHumansMalePrognosisProspective StudiesSurvival RateSwedenTime FactorsHF clinicsHFmrEFHFpEFHFrEFNew onsetOutcome

Identifiers

PMID41967095
PMCPMC13365154

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.