HFpEF-ABA Score and Finerenone in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction
Abstract
BACKGROUNDThe HFpEF-ABA score is a simple diagnostic tool developed to estimate the probability of heart failure with preserved ejection fraction (HFpEF) using age, body mass index, and history of atrial fibrillation.
OBJECTIVESThis study aims to evaluate the HFpEF-ABA score in patients with confirmed heart failure (HF) in the FINEARTS-HF trial, its prognostic implications, and the effect of finerenone treatment according to the HFpEF-ABA score.
METHODS FINEARTS-HF was a randomized, placebo-controlled trial enrolling patients with HF with a left ventricular ejection fraction $40%. HFpEF-ABA scores (as a probability between 0% and 100%) were calculated at baseline and categorized as <75%, 75%-90%, or >90%. The association between HFpEF-ABA score and clinical outcomes was examined as well as the effect of finerenone across the range of HFpEF-ABA scores. RESULTS Among 5,988 patients with available HFpEF-ABA scores, 1,940 (32.4%) had a score <75% (low probability), 1,241 (20.7%) had a score 75%-90% (intermediate probability), and 2,807 (46.9%) had a score >90% (high probability). Rates of HF outcomes were higher in patients with higher HFpEF-ABA scores. Examination of HFpEF-ABA score as a continuous variable showed a strikingly nonlinear association with outcomes; the rate of events was similar up to a score of ∼75%, above which there was a steep increase in the event rate. Finerenone reduced events consistently across HFpEF-ABA scores.
CONCLUSIONSDespite a proven diagnosis of HF with mildly reduced ejection fraction/HFpEF, one-third of participants in FINEARTS-HF had an HFpEF-ABA score <75%, yet the therapeutic effect of finerenone was consistent across the range of HFpEF-ABA scores included. Higher HFpEF-ABA scores were associated with a greater risk of HF events. (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure [FINEARTS-HF]; NCT04435626) (JACC Heart Fail.
Related
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- [Barriers to the Transition from Hospital to Home in Cardiac Rehabilitation for Patients with Heart Failure with Preserved Ejection Fraction (HFpEF)].
- Clinical outcomes of sacubitril/valsartan in patients with mildly reduced or preserved ejection fraction and acute heart failure: a multi-institutional study
- Multimodal data-driven clustering analysis of heart failure patients identifies two distinct patterns of heart failure with preserved ejection fraction: Results from the PACIFIC-PRESERVED study
- Combined Prognostic Value of Cardiac Magnetic Resonance–Derived Myocardial Extracellular Volume and the Fibrosis‐4 Index in Patients With Heart Failure With Preserved Ejection Fraction
BibTeX
@article{ono2026hfpefaba,
title = {{HFpEF-ABA Score and Finerenone in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction}},
author = {Ryohei Ono and Kieran F Docherty and Alasdair D Henderson and Brian L Claggett and Akshay S Desai and Carolyn S.P. Lam and Michele Senni and Sanjiv J Shah and Morten Schou and Adriaan A Voors and Flaviana Amarante and James Lay-Flurrie and Andrea Glasauer and Faiez Zannad and Muthiah Vaduganathan and Pardeep S Jhund and Scott D Solomon and John J.V. McMurray},
journal = {JACC: Heart Failure},
year = {2026},
month = aug,
doi = {10.1016/j.jchf.2026.103297},
url = {https://hal.univ-lorraine.fr/hal-05732842v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - HFpEF-ABA Score and Finerenone in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction
AU - Ryohei Ono
AU - Kieran F Docherty
AU - Alasdair D Henderson
AU - Brian L Claggett
AU - Akshay S Desai
AU - Carolyn S.P. Lam
AU - Michele Senni
AU - Sanjiv J Shah
AU - Morten Schou
AU - Adriaan A Voors
AU - Flaviana Amarante
AU - James Lay-Flurrie
AU - Andrea Glasauer
AU - Faiez Zannad
AU - Muthiah Vaduganathan
AU - Pardeep S Jhund
AU - Scott D Solomon
AU - John J.V. McMurray
PY - 2026
DA - 2026/08/31
JO - JACC: Heart Failure
DO - 10.1016/j.jchf.2026.103297
UR - https://hal.univ-lorraine.fr/hal-05732842v1
AB - BACKGROUNDThe HFpEF-ABA score is a simple diagnostic tool developed to estimate the probability of heart failure with preserved ejection fraction (HFpEF) using age, body mass index, and history of atrial fibrillation. OBJECTIVESThis study aims to evaluate the HFpEF-ABA score in patients with confirmed heart failure (HF) in the FINEARTS-HF trial, its prognostic implications, and the effect of finerenone treatment according to the HFpEF-ABA score. METHODS FINEARTS-HF was a randomized, placebo-controlled trial enrolling patients with HF with a left ventricular ejection fraction $40%. HFpEF-ABA scores (as a probability between 0% and 100%) were calculated at baseline and categorized as <75%, 75%-90%, or >90%. The association between HFpEF-ABA score and clinical outcomes was examined as well as the effect of finerenone across the range of HFpEF-ABA scores. RESULTS Among 5,988 patients with available HFpEF-ABA scores, 1,940 (32.4%) had a score <75% (low probability), 1,241 (20.7%) had a score 75%-90% (intermediate probability), and 2,807 (46.9%) had a score >90% (high probability). Rates of HF outcomes were higher in patients with higher HFpEF-ABA scores. Examination of HFpEF-ABA score as a continuous variable showed a strikingly nonlinear association with outcomes; the rate of events was similar up to a score of ∼75%, above which there was a steep increase in the event rate. Finerenone reduced events consistently across HFpEF-ABA scores. CONCLUSIONSDespite a proven diagnosis of HF with mildly reduced ejection fraction/HFpEF, one-third of participants in FINEARTS-HF had an HFpEF-ABA score <75%, yet the therapeutic effect of finerenone was consistent across the range of HFpEF-ABA scores included. Higher HFpEF-ABA scores were associated with a greater risk of HF events. (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure [FINEARTS-HF]; NCT04435626) (JACC Heart Fail.
SN - 2213-1779
ER -