Tost J, Llorens P, Cotter G, et al. - Antineurohormonal drugs (ANHD) were prescribed at the time of discharge in 70% of heart failure with preserved ejection fraction (HFpEF) patients who survived an acute heart failure (AHF) episode, but it seemed ANHD did not decrease mortality or adverse events in HFpEF cases, only renin-angiotensin-aldosterone-system inhibitors (RAASi) could confer some advantages, decreasing the risk of hospitalization for AHF.

• From 45 Spanish hospitals, 3,305 HFpEF patients (median age: 83, 60% women), 2,312 (70%) discharged with ANHD, were examined.

• Beta-blockers (BB) (45.8%) was most commonly prescribed ANHD.

• 1-year mortality was 26.9% (adjusted HR for ANHD patients:1.17).

• 90-day combined adverse event (revisit to emergency department –ED-, hospitalization due to AHF or all-cause death) was 54.4% (HR=1.14).

• ANHD significantly increased ED revisit (HR=1.15).

• Mineralcorticosteroid-receptor antagonis and BB were related to worse outcomes in some co-primary or secondary endpoints.