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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
PubMed

Insights

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.
Abstract

Keywords:
heart failurenatriuretic peptidespharmacistprimary preventionrisk prediction

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