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While a 2014 pooled analysis of seven RCTs concluded neither benefits nor harms of the supplementation in patients with heart failure [126], the 1993 and 2020 RCTs supported the supplementations benefit on improved endothelial function, reduced hospitalization, and reduced serious complications in patients with heart failure [127,128]

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This was further advanced in FINEARTS-HF (20242025), which addressed HFpEF challenges by reducing the composite of CV death and HF hospitalization by 16% (HR 0.84, 95% CI 0.740.95, p = 0.003), HF hospitalization by 18% (HR 0.82, 95% CI 0.710.94), CV death by 7% (HR 0.93, 95% CI 0.781.11), and total HF events by 18% (HR 0.82, 95% CI 0.710.94)