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Aims: This study investigated the S2I2N0–3 score, a simple tool comprising stroke history, insulin‐treated diabetes, and N‐terminal pro‐brain natriuretic peptide, for forecasting mortality and morbidity in heart failure (HF) with reduced ejection fraction (HFrEF). Methods and results: Analysing 890 GUIDE‐IT HFrEF trial participants, we stratified them by baseline S2I2N0–3 risk score into three risk groups. We examined the score's association with five adverse outcomes over short (90 days) and extended periods (median follow‐up of 15 months) using Cox and competing risk models. Our analysis revealed significant positive associations between the S2I2N0–3 strata and adverse outcomes. When analysed as a continuous variable, each point increment of the S2I2N0–3 score was associated with a higher risk of short‐ and long‐term cardiovascular death [short term: hazard ratio (HR) 1.43, 95% confidence interval (CI) 1.03–1.98; long term: HR 1.18, 95% CI 1.02–1.38], all‐cause death (HR 1.52, 95% CI 1.12–2.07; HR 1.18, 95% CI 1.03–1.36), HF hospitalization (HR 1.39, 95% CI 1.20–1.62; HR 1.18, 95% CI 1.06–1.31), any hospitalization (HR 1.19, 95% CI 1.06–1.34; HR 1.09, 95% CI 1.00–1.19), and the composite outcome of cardiovascular death and HF hospitalization (HR 1.39, 95% CI 1.21–1.60; HR 1.17, 95% CI 1.06–1.30). The S2I2N0–3 demonstrated reliable prognostic value, with C‐indices ranging from 0.619 to 0.753 across outcomes and time points. When compared with the Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) score using Z‐statistics, net reclassification index, and integrated discrimination improvement, the S2I2N0–3 showed comparable predictive power for all outcomes during both short‐ and long‐term follow‐ups. Conclusions: The S2I2N0–3 risk score had modest predictive values for both short‐ and long‐term clinical outcomes in HFrEF patients, offering equivalent performance to the established MAGGIC score. [ABSTRACT FROM AUTHOR]

Living alone is an objective sign of social isolation. It is uncertain whether living alone worsens clinical outcomes in heart failure (HF) patients. We aimed to assess how living alone affected clinical outcomes in individuals with HF. We searched the electronic databases of PubMed, Embase, and Cochrane from 1990 to April 2022 for studies comparing living alone with HF. A random‐effects model with inverse variance was used to pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Seven studies were deemed to meet the standards. In patients with HF, compared with living with others, living alone was associated with an elevated risk of any hospitalization at the 30‐day (HR: 1.78, 95% CI: 1.09–2.89), 90‐day (HR: 1.24, 95% CI: 1.02–1.51), or ≥1‐year (HR: 1.14, 95% CI: 1.04–1.26) follow‐up periods. HF patients living alone also had a greater risk of any hospitalization or death at the 30‐day (HR: 1.56, 95% CI: 1.15–2.11), 90‐day (HR: 1.26, 95% CI: 1.05–1.50), and ≥1‐year (HR: 1.18, 95% CI: 1.09–1.28) follow‐up periods. However, patients living alone had no increased risk of all‐cause death at the 30‐day (HR: 1.0, 95% CI: 0.19–5.36), 90‐day (HR: 0.46, 95% CI: 0.03–7.42), or ≥ 1‐year (HR: 1.10, 95% CI: 0.73–1.67) follow‐up periods. In comparison to living with others, living alone was associated with an increased risk of any hospitalization but not all‐cause death in HF patients. [ABSTRACT FROM AUTHOR]

Background: Transthyretin amyloid cardiomyopathy (ATTR‐CM) is often found in patients with heart failure with preserved ejection fraction (HFpEF). However, the evidence regarding ATTR‐CM and prognosis in HFpEF remains scarce. This study sought to determine whether the ATTR‐CM burden was associated with clinical outcomes in HFpEF patients. Methods: We evaluated the associations of baseline ATTR‐CM score with adverse outcomes in HFpEF patients from the TOPCAT trial using the Cox proportional hazards model or the competing risk regression model. The discriminatory ability of the ATTR‐CM score was assessed using the area under the time‐dependent receiver operating characteristic curve (AUC). Results: We included 870 HFpEF patients, 18.9% of which had an ATTR‐CM score ≥6. Per 1 increment in the ATTR‐CM score was significantly associated with an increased risk of the primary outcome (adjusted hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.12–1.27) with an AUC of 0.652 (0.594–0.711), whereas patients with ATTR‐CM score ≥6 presented higher risks of the primary outcome (adjusted HR 2.20, 95% CI 1.65–2.95). Similar results were observed toward the secondary outcomes. Conclusions: The simple ATTR‐CM score identified an 18.9% ATTR‐CM burden in HFpEF patients, and a higher ATTR‐CM burden might predict adverse outcomes with moderate discriminatory abilities in HFpEF. [ABSTRACT FROM AUTHOR]