Enhance understanding of emerging clinical phenotypes of HF

Insights generated from the OM1 Heart Failure Premium Dataset

Understanding HF Patient Phenotypes, Disease Progression, and Management

Figure 1

It is thought that patients with mid-range HF (HFmrEF: LVEF 40%-50%) have a clinical profile and prognosis that are closer (in general) to those of patients with preserved HF (HFpEF: ≥50%) than those of reduced HF (HFrEF: ≤40%).

In a longitudinal evaluation of HFmrEF patients in the OM1 HF Premium Dataset* (Jan 2022; N=177,781), over half the patients are later characterized as preserved (HFpEF) or reduced EF (HFrEF).

Understanding the trajectory and prognosis of specific subsets of HFmrEF patients may help guide management of this more recently established phenotype.

Fig 1. HFmrEF longitudinal status

Figure 2

Unlike the HFmrEF patients, transition between EF categories is much less common in patients initially identified as preserved.

Fig 2. pEF longitudinal status

Understanding HF Patient Comorbidities and Impact on Disease Progression and Treatment Management

Figure 3

Because over 80% HF patients are ≥65 years, most of these patients suffer from one or more comorbidities. The burden of comorbidities in patients with HF is high, including patients with HFpEF, and can complicate management.

As seen in the OM1 HF Premium Dataset*, over half of the patients are obese and many also suffer from hypertension (73%) and hyperlipidemia (53%). Patients with particular metabolic phenotypes (e.g., with diabetes, metabolic syndrome, or obesity) may have different disease trajectories and benefit from tailored management strategies.

*Formerly called the OM1 HF Registry

Figure 3. HFpERF by comorbidity

Understanding Treatment of HF Patients with Comorbidities

Figure 4

Patients with particular metabolic phenotypes may have a different disease trajectories and benefit from tailored management strategies.

In the 2022 analysis of the HF PremiOM dataset, patterns of GLP-1 and SGLT-2 use were observed among HF patients also diagnosed with obesity, type II diabetes (T2DM), hypertension, and NASH.

Patients with both obesity and T2DM were observed to have more usage of these medications than patients with only obesity or T2DM as comorbid conditions. Similarly, patients with diagnoses of hypertension or NASH had increased usage of these medications.

These distributions may shift as agents are utilized more widely in non-diabetic HF populations.

Figure 4. Use of GLP-1 and SGLT-2 medications in HF patients with metabolic comorbidities