Health Services and Outcomes Research Trends in Patients Hospitalized With Heart Failure and Preserved Left Ventricular Ejection Fraction Prevalence, Therapies, and Outcomes

Background—Heart failure with preserved ejection fraction (EF) is a common syndrome, but trends in treatments and outcomes are lacking. the proportion of hospitalizations for HF–preserved EF increased from 33% to 39% (PϽ0.0001). In multivariable analyses, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at discharge decreased in all EF groups, and ␤-blocker use increased. Patients with HF–preserved EF less frequently achieved blood pressure control (adjusted odds ratio, 0.44 versus HF–reduced EF; PϽ0.001) and were more likely discharged to skilled nursing (adjusted odds ratio, 1.16 versus HF–reduced EF; PϽ0.001). In-hospital mortality for HF–preserved EF decreased from 3.32% in 2005 to 2.35% in 2010 (adjusted odds ratio, 0.89 per year; Pϭ0.01) but was stable for patients with HF–reduced EF (3.03%–2.83%; adjusted odds ratio, 0.93 per year; Pϭ0.10). Conclusions—Hospitalization for HF–preserved EF is increasing relative to HF–reduced EF. Although in-hospital mortality for patients with HF–preserved EF declined over the study period, an important opportunity remains for identifying evidence-based therapies in patients with HF–preserved EF.