Only with additional work, if the attacker also extracts your password file. That's something I'd like some resistance against anyway, so malware can't simply do that and potentially decrypt it a few years down the line.

This of cause doesn't help against a resourceful and highly targeted attack, but that's less of a concern for me than some malware toolbox adding support for common password managers.

Also, on Windows, KeePass at least offers the option to always ask for the master password only in the same secure desktop that UAC and login/logout use. (I don't know why this isn't the default behavior, other than maybe cross-platform compat, but it is not the default. First thing I turn on for fresh installs.) That at least helps mitigate against most software keyloggers / remote automation hack attempts. (Leading the threat concerns back to rootkits and physical hardware access.)