# PREFERS Stockholm: nieuw ontstaan HFpEF heeft slechtere langetermijnuitkomsten dan HFrEF en HFmrEF

*geplaatst 2026-07-19 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag105 · https://hartvaat.nl/2026/04/09/prefers-stockholm-nieuw-ontstaan-hfpef-heeft-slechtere-langetermijnuitkomsten-da/*

Prospectieve uitkomstgegevens voor nieuw ontstaan hartfalen (HF) per ejectiefractiecategorie zijn schaars. De Stockholmse PREFERS-studie volgde 547 patiënten met nieuw ontstaan HF, behandeld in gespecialiseerde HF-poliklinieken (HFpEF 25%, HFmrEF 11%, HFrEF 64%; mediane EF 55%, 45% en 30%). Het primaire eindpunt was cardiovasculaire sterfte of eerste hartfalenopname. Over een mediane follow-up van 3,8 jaar hadden HFpEF-patiënten een hóger risico op het primaire eindpunt dan HFmrEF en HFrEF samen (gecorrigeerde HR 1,7). Bovendien daalde na één jaar het NT-proBNP fors bij HFmrEF (-42%) en HFrEF (-55%) met een stijging van de EF, terwijl bij HFpEF de EF juist 5 procentpunt daalde en het NT-proBNP onveranderd bleef. De studie onderstreept de ernst van HFpEF — vaak onderschat — en de behoefte aan effectievere behandelstrategieën.

## English: Worse Long-Term Outcomes in New-Onset HFpEF vs HFrEF and HFmrEF: Findings from the Stockholm PREFERS Study.

Prospective outcome data for new-onset heart failure (HF) by ejection-fraction category are scarce. The Stockholm PREFERS study followed 547 patients with new-onset HF treated in specialised HF clinics (HFpEF 25%, HFmrEF 11%, HFrEF 64%; median EF 55%, 45% and 30%). The primary endpoint was cardiovascular death or first HF hospitalisation. Over a median 3.8-year follow-up, HFpEF patients had a higher risk of the primary endpoint than HFmrEF and HFrEF combined (adjusted HR 1.7). Moreover, at one year NT-proBNP fell markedly in HFmrEF (-42%) and HFrEF (-55%) with rising EF, whereas in HFpEF the EF actually fell by 5 percentage points and NT-proBNP was unchanged. The study underscores the severity of HFpEF — often underestimated — and the need for more effective treatment strategies.

## Abstract (original, from the publication)

AIMS: Prospective 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 RESULTS: Between 2015 and 2019, 547 patients were enrolled: HFpEF n=135 (25%), HFmrEF n=61 (11%), HFrEF n=351 (64%). Mean age was 76, 71, and 67 years for HFpEF, HFmrEF, and HFrEF; median baseline EF was 55%, 45%, and 30% (all p<0.001 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. 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<0.001; adjusted HR 1.7; 95% CI 1.1-2.9; p<0.05). 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<0.05) and in HFrEF by 55% (p<0.001), with EF increases of 2 percentage points (pp) (p<0.05) and 16 pp (p<0.001), respectively. In HFpEF, EF decreased by 5 pp (p<0.001) with no change in NT-proBNP. CONCLUSIONS: In 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.

Auteurs: Hans Persson, Anton Winderud, Camilla Hage, Carin Corovic Cabrera, Ulrika Löfström, Patrik Lyngå, Taner Arslan, Karin Knudsen-Malmqvist, Maria J Eriksson, Bengt Persson, Håkan Wallen, Mattias Ekström, Cecilia Linde

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag105. Bijgewerkt 2026-07-04T19:26:56Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.