Recurrent heart failure hospitalizations have been used as a surrogate end point in clinical studies of heart failure for decades due to the associations of this end point with adverse long-term prognosis for the individual patient and increased costs to payers. 1,2 Given the strength of the association of recurrent heart failure hospitalizations and mortality as well as the inherent morbidity of admission for heart failure, recurrent heart failure hospitalizations have been commonly used as both a key component of primary composite end points for major heart failure clinical trials as well as a closely monitored individual secondary end points in the same studies.