(P-481) Characteristics of Asymptomatic Heart Failure Patients with Reduced Ejection Fraction in a Large Us-based Real-world Cohort

Background: Asymptomatic left ventricular dysfunction (ALVD) is characterized by having evidence of structural heart disease without clinical symptoms of heart failure (HF). The prevalence of ALVD is estimated to be as high as that of overt HF; however, due to lack of symptoms and screening protocols often remains undetected. Understanding characteristics of asymptomatic patients with reduced left ventricular ejection fraction (LVEF) can help to identify patients at risk for progression to later stage HF who may benefit from more intensive monitoring and management and provide support for identifying patients at elevated risk for ALVD.

Objectives: To characterize asymptomatic HF patients with reduced LVEF and compare patient characteristics and management to symptomatic HF patients.

Methods: The data source for this analysis was the OM1 HF Registry, a real-world cohort of patients followed longitudinally as part of a large, deterministically linked clinical and administrative dataset in the U.S. derived from medical and pharmacy claims, electronic medical record (EMR) data, and death data. This analysis included data from January 2013 to October 2020. Adult patients with HF were included if they had reduced LVEF (defined as ≤ 40%) prior to or on the date of their most recent New York Heart Association (NYHA) classification (index date) and had at least 12 months of baseline data. Asymptomatic patients were defined by NYHA Class I. Descriptive analyses of patients by NYHA Class I-IV were conducted.

Results: Of the 142,086 patients in the OM1 HF Registry, 10,329 patients met the inclusion criteria and 2,453 were NYHA Class I. The mean age of NYHA Class I patients was 72 years and 73% of patients were male. Prevalence of selected comorbidities differed by NYHA class, with Type 2 diabetes ranging from 20% to 32% and chronic kidney disease ranging from 14% to 31%, for NYHA Class I and NYHA Class IV, respectively. The proportion of patients on beta-blocker plus renin-angiotensin-aldosterone system inhibitors (RAASi) ranged from 23% to 34% and the proportion with at least one hospitalization in the 12 months prior to index ranged from 22% to 57%, for NYHA Class I and NYHA Class IV, respectively.

Conclusions: Compared to symptomatic HF patients (NYHA Class II-IV), asymptomatic patients (NYHA Class I) had a lower but still notable prevalence of comorbidities, medication use, and hospitalization, highlighting the need to identify and manage these patients to prevent progression to symptomatic HF.