Risk Factors For Sudden Death in Heart Failure with Preserved Ejection Fraction

MedicalResearch.com Interview with:

Muthiah Vaduganathan, MD MPH Heart and Vascular Center Brigham and Women's Hospital 

Dr. Vaduganathan

Muthiah Vaduganathan, MD MPH
Heart and Vascular Center
Brigham and Women’s Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The prevalence of heart failure with preserved ejection fraction (HFpEF) is rising globally, yet no medical therapies are currently available to alter its natural history and its progression remains incompletely understood.

Sudden death may represent a target for therapy in this disease entity. In 1,767 patients with HFpEF enrolled in the Americas region of the TOPCAT trial, we found that sudden death accounts for ~20% of all deaths. Male sex and insulin-treated diabetes mellitus identify patients at higher risk for sudden death. Sudden death was numerically lower but not statistically reduced in those randomized to spironolactone.

 MedicalResearch.com: What should readers take away from your report?

Response: The findings of this competing risks analysis from the TOPCAT trial are consistent with prior analyses from I-PRESERVE, another large cardiovascular outcomes trial in HFpEF. Male sex and diabetes mellitus appear consistently associated with higher risks of sudden death. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further studies are required to define mechanisms contributing to sudden death, build more robust sudden death risk prediction models integrating imaging and biomarkers, and develop strategies to attenuate sudden death risk in HFpEF.

Disclosures: I receive support from the NHLBI T32 postdoctoral training grant (T32HL007604).

Citations:  upcoming ACC abstract:

Sudden Death in Heart Failure with Preserved Ejection Fraction: A Competing Risks Analysis from the TOPCAT Trial




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