Figure 3.

Categorizing patients by zones according to Trial Score and H₂FPEF score. (A) Zone definitions for categorizing patients by concomitant TS and H₂FPEF score: Zone 1: HFpEF is unlikely (H₂FPEF score ≤ 2). Zone 2: HFpEF is likely (H₂FPEF score ≥ 3), and the patient is well represented in TOPCAT but unlikely benefit from spironolactone (TS < 1.14). Zone 3: HFpEF is likely (H₂FPEF score ≥ 3), and the patient is well represented in TOPCAT and likely benefit from spironolactone (1.14 ≤ TS < 2.63). Zone 4: HFpEF is likely (H₂FPEF score ≥ 3), but the patient is not well represented in TOPCAT, so there is unclear benefit from spironolactone (TS ≥ 2.63). (B) Distributions across zones for TOPCAT participants from the Americas and Eastern Europe and also for the validated HFpEF patient registry. Only those with echocardiographic data, required for H₂FPEF score, were included. Each individual is shown along with a density plot overlay. Percentages in each zone are denoted. All three population distributions were significantly different from each other (P < 0.0001 by χ² for overall comparison and for each pair), although the patient registry more closely resembled the TOPCAT Americas participants.