Trajectories in New York heart association functional class across the ejection fraction spectrum: data from the Swedish Heart Failure registry

To investigate incidence, predictors and prognostic implications of longitudinal New York Heart Association (NYHA) class changes (i.e. improving or worsening vs. stable NYHA class) in heart failure (HF) across the ejection fraction (EF) spectrum. In a large real‐world HF population, NYHA class trajectories predicted morbidity/mortality after extensive adjustments. However, the prognostic role was entirely explained by the resulting NYHA class, i.e. the follow‐up value. Results highlight that considering one‐time NYHA class assessment, rather than trajectories, might be the preferable approach in clinical practice and for clinical trial design.