To the Editor: Shen et al. (July 6 issue)1 report declining rates of sudden death among patients with heart failure and reduced ejection fraction who were enrolled in trials spanning the period from 1995 through 2014. This message is one of hope,2 contrasting with a traditionally more pessimistic narrative.3 However, why use simple linear regression? A spline term may better fit the data in Figure 1 (available with the full text of the article at NEJM.org). The patients in the control groups of the BEST (Beta-Blocker Evaluation of Survival) trial, RALES (Randomized Aldactone Evaluation Study), and MERIT-HF (Metoprolol CR/XL Randomised . . .

中文翻译：

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心力衰竭突然死亡的风险下降

致编辑：Shen等。（7月6日，第1期）报道了1995年至2014年期间参加试验的心力衰竭和射血分数降低的患者的猝死率下降。这一信息是希望之一，2与传统上更为悲观的叙述相反。 3但是，为什么要使用简单的线性回归呢？样条项可能会更好地拟合图1中的数据（可在NEJM.org上的文章全文中找到）。最佳（Beta-Blocker评估生存期）试验，RALES（随机化的醛固酮评估研究）和MERIT-HF（美托洛尔CR / XL随机分组）的对照组为患者。