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Feasibility of the Implementation of Tools for Heart Failure Risk Prediction: A Randomized Controlled Pilot Trial.
Michael C Wang1, Bridget Dolan2, Xiaoning Huang3
1Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
JACC. Advances
|July 15, 2025
Summary
This pilot study shows that risk-based heart failure (HF) prevention is feasible. While B-type natriuretic peptide levels did not significantly change, high-sensitivity cardiac troponin I levels decreased in the intervention group.
Area of Science:
- Cardiology
- Preventive Medicine
- Clinical Trials
Background:
- The 2022 ACC/AHA guidelines advocate for multivariable risk equations in heart failure (HF) prevention.
- Prospective assessment of this risk-based strategy for HF prevention was lacking.
Purpose of the Study:
- To determine the feasibility of implementing risk-based strategies for preventing heart failure.
- To evaluate the impact of a collaborative care model with a pharmacist on HF risk markers.
Main Methods:
- The Feasibility of the Implementation of Tools for Heart Failure Risk Prediction (FIT-HF) study was a randomized controlled pilot trial.
- Patients with a predicted 10-year HF risk ≥5% were randomized to usual care or collaborative care with a pharmacist.
- Biomarkers (BNP, hs-cTn) and echocardiography were assessed at baseline and 1-year follow-up.
Main Results:
- 82 participants completed the 1-year follow-up.
- The intervention group showed a statistically significant reduction in high-sensitivity cardiac troponin I (hs-cTn) levels (-1.8, P=0.03).
- No significant difference was observed in the primary outcome, B-type natriuretic peptide (BNP) levels, between groups (P=0.13).
Conclusions:
- The FIT-HF study confirms the feasibility of enrolling patients for risk-based HF prevention using predicted risk scores.
- Larger trials are necessary to establish the efficacy and long-term effects of these preventive interventions.
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