{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:52:12Z","timestamp":1789228332925,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The global burden of heart failure (HF) is rising, with a shift towards more cases of heart failure with preserved ejection fraction (HFpEF). Given evolving epidemiology, an updated assessment of outcome differences between HFpEF and heart failure with reduced ejection fraction (HFrEF) is needed. This systematic review and meta-analysis aimed to provide a contemporary, large-scale comparison of clinical outcomes between HFpEF and HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis were conducted to compare all-cause mortality, cardiovascular (CV) mortality, and HF hospitalizations in HFpEF (EF: &amp;gt;50%) and HFrEF (EF: &amp;lt;40%). Risk ratios (RR) and maximally adjusted hazard ratios (HR) with 95% confidence intervals (CI) were pooled using random-effects models. Additional analyses included prior HF hospital admissions, in-hospital mortality, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 101 studies were included. HFpEF patients had lower all-cause mortality [RR: 0.78; 95% CI: 0.69\u20130.88; P &amp;lt; .001; adjusted HR: 0.71; 95% CI: 0.62\u20130.80; P &amp;lt; .001; 112 vs 148 per 1000 patient-years (PY)], CV mortality [RR: 0.64; 95% CI: 0.53\u20130.79; P &amp;lt; .001; adjusted HR: 0.65; 95% CI: 0.56\u20130.75; P &amp;lt; .001; 73 vs 110 per 1000 PY], and HF hospitalizations [RR: 0.75; 95% CI: 0.63\u20130.91; P = .003; adjusted HR: 0.87; 95% CI: 0.78\u20130.98; P = .02; 171 vs 225 per 1000 PY] compared to HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HFpEF patients experience lower mortality and hospitalization risks than HFrEF patients, even after adjustment for confounders. However, high absolute event rates in HFpEF highlight the need for effective treatment strategies to improve outcomes.<\/jats:p>\n                    <jats:p>PROSPERO registration ID: CRD42024619499.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag026","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:39:02Z","timestamp":1768394342000},"source":"Crossref","is-referenced-by-count":3,"title":["Mortality and heart failure hospitalizations in heart failure with preserved ejection fraction compared to heart failure with reduced ejection fraction: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9699-1686","authenticated-orcid":false,"given":"Krzysztof","family":"Irlik","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, 6 W Derby St , Liverpool L7 8TX ,","place":["UK"]},{"name":"Doctoral School, Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Pia\u015bnik","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Hendel","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urszula","family":"Faron","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, 6 W Derby St , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Clinical Medicine, Aalborg University , Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0777-8048","authenticated-orcid":false,"given":"Katarzyna","family":"Nabrdalik","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, 6 W Derby St , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Prokopidis","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, 6 W Derby St , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool , 6 W Derby St, Liverpool L7 8TX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"2026021208461083100_xvag026-B1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1038\/nrcardio.2017.65","article-title":"Epidemiology of heart failure with preserved ejection fraction","volume":"14","author":"Dunlay","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"2026021208461083100_xvag026-B2","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1056\/NEJMoa052256","article-title":"Trends in prevalence and outcome of heart failure with preserved ejection fraction","volume":"355","author":"Owan","year":"2006","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B3","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1056\/NEJMoa051530","article-title":"Outcome of heart failure with preserved ejection fraction in a population-based study","volume":"355","author":"Bhatia","year":"2006","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B4","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1093\/eurheartj\/ehr254","article-title":"The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis","volume":"33","author":"Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)","year":"2012","journal-title":"Eur Heart J"},{"key":"2026021208461083100_xvag026-B5","doi-asserted-by":"publisher","first-page":"1770","DOI":"10.1093\/eurheartj\/ehy005","article-title":"Mortality associated with heart failure with preserved vs. reduced ejection fraction in a prospective international multi-ethnic cohort study","volume":"39","author":"Lam","year":"2018","journal-title":"Eur Heart J"},{"key":"2026021208461083100_xvag026-B6","doi-asserted-by":"publisher","first-page":"2476","DOI":"10.1016\/j.jacc.2017.08.074","article-title":"Heart failure with preserved, borderline, and reduced ejection fraction","volume":"70","author":"Shah","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2026021208461083100_xvag026-B7","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/j.jchf.2018.03.006","article-title":"Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction","volume":"6","author":"Tsao","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2026021208461083100_xvag026-B8","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2026021208461083100_xvag026-B9","doi-asserted-by":"publisher","first-page":"80","DOI":"10.13105\/wjma.v5.i4.80","article-title":"Assessing the quality of studies in meta-analyses: advantages and limitations of the Newcastle Ottawa Scale","volume":"5","author":"Luchini","year":"2017","journal-title":"World J Metaanal"},{"key":"2026021208461083100_xvag026-B10","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"2026021208461083100_xvag026-B11","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"2026021208461083100_xvag026-B12","doi-asserted-by":"publisher","first-page":"e611","DOI":"10.1016\/S2214-109X(23)00605-8","article-title":"Mortality in patients admitted to hospital with heart failure in China: a nationwide Cardiovascular Association Database-Heart Failure Centre Registry cohort study","volume":"12","author":"Wang","year":"2024","journal-title":"Lancet Glob Health"},{"key":"2026021208461083100_xvag026-B13","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1056\/NEJMoa2206286","article-title":"Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction","volume":"387","author":"Solomon","year":"2022","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B14","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1056\/NEJMoa2107038","article-title":"Empagliflozin in heart failure with a preserved ejection fraction","volume":"385","author":"Anker","year":"2021","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B15","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.jchf.2021.09.004","article-title":"A systematic review and network meta-analysis of pharmacological treatment of heart failure with reduced ejection fraction","volume":"10","author":"Tromp","year":"2022","journal-title":"JACC Heart Fail"},{"key":"2026021208461083100_xvag026-B16","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1002\/ejhf.486","article-title":"Thirty-year trends in heart failure hospitalization and mortality rates and the prognostic impact of co-morbidity: a Danish nationwide cohort study","volume":"18","author":"Schmidt","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026021208461083100_xvag026-B17","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1080\/14017431.2017.1311023","article-title":"Prevalence of heart failure in the elderly and future projections: the AGES-Reykjav\u00edk study","volume":"51","author":"Danielsen","year":"2017","journal-title":"Scand Cardiovasc J"},{"key":"2026021208461083100_xvag026-B18","doi-asserted-by":"publisher","first-page":"e011366","DOI":"10.1161\/CIRCHEARTFAILURE.123.011366","article-title":"Uncovering unrecognized heart failure with preserved ejection fraction among individuals with obesity and dyspnea","volume":"17","author":"Kosyakovsky","year":"2024","journal-title":"Circ Heart Fail"},{"key":"2026021208461083100_xvag026-B19","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B20","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-weekly semaglutide in adults with overweight or obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B21","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1136\/heartjnl-2018-314173","article-title":"Prognosis and NT-proBNP in heart failure patients with preserved versus reduced ejection fraction","volume":"105","author":"Salah","year":"2019","journal-title":"Heart"},{"key":"2026021208461083100_xvag026-B22","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jacc.2005.09.022","article-title":"Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database","volume":"47","author":"Yancy","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2026021208461083100_xvag026-B23","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B24","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and cardiovascular outcomes in type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B25","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","article-title":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet"},{"key":"2026021208461083100_xvag026-B26","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1056\/NEJMoa2410027","article-title":"Tirzepatide for heart failure with preserved ejection fraction and obesity","volume":"392","author":"Packer","year":"2024","journal-title":"N Engl J Med"},{"key":"2026021208461083100_xvag026-B27","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1016\/j.jacc.2023.01.049","article-title":"Heart failure with preserved ejection fraction","volume":"81","author":"Borlaug","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2026021208461083100_xvag026-B28","doi-asserted-by":"publisher","first-page":"103462","DOI":"10.1016\/j.eclinm.2025.103462","article-title":"Machine learning-based phenotyping and assessment of treatment responses in heart failure with preserved ejection fraction","volume":"88","author":"Li","year":"2025","journal-title":"EClinicalMedicine"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag026\/66428666\/xvag026.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/13\/1\/xvag026\/66428666\/xvag026.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/13\/1\/xvag026\/66428666\/xvag026.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T13:46:19Z","timestamp":1770903979000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/doi\/10.1093\/eschf\/xvag026\/8427159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,16]]},"published-print":{"date-parts":[[2026,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/eschf\/xvag026","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,16]]},"article-number":"xvag026"}}