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February 6, 2026European Heart Journal

The PREVENT equations predict clinical outcomes in heart failure with preserved ejection fraction

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Why the study?

Although the AHA PREVENT equations were developed for primary prevention, they incorporate factors relevant to HF; whether they predict clinical outcomes in HFpEF was unknown.

Do the PREVENT equations predict major adverse cardiovascular events in patients with HFpEF?

Population

434 patients aged 30 to 79 years with HFpEF (280 analyzed)

Comparison

PREVENT risk equations (PREV-CVD, PREV-HF, PREV-ASCVD)

Design

Prospective multicenter observational study cohort

Follow-up

Median 1384 days (IQR 882-1785)

Key result

The PREVENT equations independently predicted major adverse cardiovascular events in patients with HFpEF, with the PREV-CVD score showing a significant association (HR 1.04; 95% CI 1.02-1.07).

Authors

KIK IwakuraNTNobuaki TanakaMOM Okada

Discussion

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Overview

May support risk stratification in HFpEF; extends PREVENT validation but remains hypothesis-generating and should not yet change practice.

Key Points

  • This research aims to assess the predictive power of PREVENT equations for clinical outcomes in heart failure with preserved ejection fraction.
  • Enrolled 434 patients aged 30 to 79 from the PURSUIT-HFpEF study.
  • Used PREVENT online calculator to determine 10-year risks of cardiovascular disease, heart failure, and atherosclerotic cardiovascular disease.
  • Monitored Major Adverse Cardiovascular Events (MACE) over a median follow-up of 1384 days.
  • 125 patients experienced MACEs during the follow-up period.
  • PREVENT scores were independent predictors of MACEs and HF hospitalisation.
  • Time-dependent ROC curve analysis indicated good predictive ability for MACEs and HF hospitalisation at 1 and 3 years.

Study Design

Type

Observational (n=280)

Multicenter

Yes

Structured PICO

Do the PREVENT equations predict major adverse cardiovascular events in patients with HFpEF?

P
Population
280 patients aged 30 to 79 years with heart failure with preserved ejection fraction (HFpEF) from the PURSUIT-HFpEF study, mean age 75 years, 48.6% female.
I
Intervention
PREVENT equations (10-year risks of cardiovascular disease [PREV-CVD], heart failure [PREV-HF], and atherosclerotic cardiovascular disease [PREV-ASCVD])
O
Outcome
Major adverse cardiovascular events (MACE), a composite of death, HF hospitalisation (HHF), and strokecomposite

Main Result

Effect estimate: HR 1.04 (95% CI 1.02-1.07)

p-value: p=0.00004

The PREVENT equations, originally designed for primary prevention, effectively predict major adverse cardiovascular events and heart failure hospitalizations in patients with HFpEF.

Cite This Study

Iwakura et al. (2025) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=280). PREVENT equations was evaluated on Major adverse cardiovascular events (MACE), a composite of death, HF hospitalisation (HHF), and stroke (HR 1.04, 95% CI 1.02-1.07, p=0.00004). The PREVENT equations independently predicted major adverse cardiovascular events in patients with HFpEF, with the PREV-CVD score showing a significant association (HR 1.04; 95% CI 1.02-1.07).

synapsesocial.com/papers/698586118f7c464f23009f80https://doi.org/10.1093/eurheartj/ehaf784.1121
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