Temporal comparison of clinical practice and outcomes in heart failure: the JROADHF and JROADHF-NEXT studies.

Authors

Takeshi Tohyama, Masataka Ikeda, Tatsuya Watanabe, Nobuyuki Enzan, Hidetaka Kaku, Eri Noda, Takuya Nagata, Yoshitomo Tsutsui, Shouji Matsushima, Yuya Matsue, Keisuke Kida, Takeshi Kitai, Tatsunori Taniguchi, Takahiro Okumura, Koshiro Kanaoka, Yoko Sumita, Yoshihiro Miyamoto, Kohtaro Abe, Hiroyuki Tsutsui, Tomomi Ide

Published in

European heart journal. Aug 08, 2026. Epub Aug 08, 2026.

Abstract

Advances in therapeutics and interventions have enabled the comprehensive management of patients with heart failure (HF); however, real-world clinical practice remains poorly characterized. This study aimed to evaluate temporal changes in HF management and their impact on patient outcomes.
Two large-scale Japanese HF registries were compared: the JROADHF (2013, n = 13 238) and JROADHF-NEXT (2019-21, n = 4016). Propensity score matching (1:1) was performed to compare patient outcomes between cohorts and identify factors associated with outcome improvements.
Propensity score matching yielded 2972 patients in each cohort. After matching, guideline-recommended therapy increased for renin-angiotensin system inhibitors (70.9% vs 73.1%), beta-blockers (74.9% vs 80.8%), mineralocorticoid receptor antagonists (54.2% vs 61.1%), cardiac rehabilitation (43.5% vs 88.8%), and nutritional guidance (2.9% vs 56.1%) in the 2013 and 2019-21 cohorts, respectively. The 2019-21 cohort demonstrated 26.7% and 52.1% reductions in 1-year mortality and HF readmission rate (P < .001 for both), respectively, compared with the 2013 cohort. Improved mortality was associated with pharmacotherapy [renin-angiotensin system inhibitors: hazard ratio (HR) .71, 95% confidence interval (CI) .64-.80, P < .001; beta-blockers: HR .85, 95% CI .75-.96, P = .012] and patient education (nutritional guidance: HR .76, 95% CI .64-.89, P = .001). The cohort effect was the strongest predictor of HF readmission (subdistribution HR .49, 95% CI: .43-.57, P < .001).
Long-term outcomes of patients with HF improved between 2013 and 2019-21. Guideline-recommended therapy was associated with survival benefit, whereas marked reduction in HF readmission rates coincided with broader changes in post-discharge care and healthcare system.

PMID:
42568038
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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