New findings from a reanalysis of the FIGHT trial reveal significant racial and ethnic disparities in how patients recover after hospitalization for heart failure with reduced ejection fraction. The study, presented at the American College of Cardiology’s 2025 scientific sessions, examined outcomes for 289 adults and uncovered sharply different experiences depending on race.
Non-White patients entered the trial at a clear disadvantage. They were significantly younger—55 compared with 64 years for White patients—yet already had more severe disease. Their average left ventricular ejection fraction was lower, at 21% versus 25%, and they walked far shorter distances on the six-minute walk test, a measure of functional status. These early differences signaled a more fragile baseline for patients of color.
Six months after hospitalization, the gap widened. Although mortality rates were similar, non-White participants were more likely to land back in the hospital for heart failure. Their readmission rate reached 45%, compared with 33% for White patients. Biomarker data also suggested greater deterioration. NT-proBNP levels, which rise as heart failure worsens, increased far more among non-White patients—253 pg/mL compared with 196 pg/mL in White patients.
Justin Mark, MD, who presented the analysis, emphasized that these trends emerged regardless of treatment assignment in the original trial. The results show that even in a controlled clinical setting, racial and ethnic groups experience heart failure differently, with non-White patients facing more severe disease and worse recovery trajectories.
See: “Racial, Ethnic Differences in Heart Failure Outcomes, with Justin Mark, MD” (March 31, 2025)
