Generalizability of HFrEF trials 29 age, percentage of women, percentage in NYHA class III/IV and mean LVEF, except for percentage with atrial fibrillation which was lower in this study.42 It is also necessary to note that, although registry patients are a fair representation of realworld patients, there are likely to be some differences in characteristics and treatment practices between patients who were and were not enrolled in the registries. We also acknowledge that the trial and real-world populations differed on geographical location, healthcare systems and time of data collection.43 CONCLUSION In summary, over half of patients in registries met the most commonly used in- and ex- clusion criteria for potential trial enrolment. In terms of generalisability, age and sex were the main drivers of differences in clinical outcomes between HF trials and observational HF registries. As expected, HF trial participants showed higher residual cardiovascular mortality rates after correction for case mix. 2.1
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