There was a stepwise gradient of risk for the primary efficacy outcome of cardiovascular death or worsening heart failure event according to timing of the most recent heart failure hospitalization. This risk gradient remained significant after adjusting for age, sex, race, left ventricular ejection fraction, baseline N-terminal pro-B-type natriuretic peptide concentration, and New York Heart Association class (compared with patients never hospitalized for HF, adjusted hazard ratios were 1.08 [95% CI, 0.90-1.29] and 1.30 [95% CI, 1.12-1.51] for those hospitalized >12 months ago and ≤12 months ago, respectively; P = .003).