Avula HR, et al. - In a diverse population of adults with heart failure (HF) and reduced ejection fraction (HFrEF), HF and borderline preserved ejection fraction (HFbEF), and HF and preserved ejection fraction (HFpEF), clinical outcomes including death, HF hospitalization, and HF-related emergency department (ED) visit were analyzed. Using electronic records, information on demographics, clinical characteristics, and therapies was obtained for adults with diagnosed HF between 2005 and 2012 in Kaiser Permanente Northern California. The outcomes were assessed among patient groups formed on the basis of left ventricular systolic function: HFpEF (EF ≥ 50%), HFbEF (EF 41-49%), or HFrEF (EF ≤ 40%). HFpEF and HFbEF patients demonstrated similar adjusted rates of death, HF hospitalization, and HF-related ED visits, while these were reported to be higher in HFrEF patients. High long-term mortality and morbidity was observed in all HF patients irrespective of systolic function, emphasizing the necessity of novel strategies to improve long-term outcomes.