In a post hoc analysis of the FINEARTS-HF randomized clinical trial including 6,001 patients with heart failure with mildly reduced or preserved ejection fraction, researchers found that sudden death was preceded by modest worsening in New York Heart Association class, declining patient-reported health status, and rising N-terminal pro–B-type natriuretic peptide levels in the months before death, suggesting these events may not be entirely abrupt. However, similar or more pronounced patterns of clinical deterioration were observed prior to other modes of death, indicating that these trajectories reflect overall increased mortality risk rather than providing specific predictive value for sudden death.

Source: JAMA Original Investigation, Editor’s Note