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Outcomes by gender in the African-American Heart Failure Trial.
J Am Coll Cardiol. 2006 Dec 05; 48(11):2263-7.JACC

Abstract

OBJECTIVES

Previous trials testing isosorbide dinitrate/hydralazine (I/H) were performed in all-male study cohorts, and thus the efficacy of I/H in women was unknown; 40% of the A-HeFT (African-American Heart Failure Trial) cohort were women. We therefore compared outcomes by gender and treatment.

BACKGROUND

Fixed-dose combined I/H significantly reduced mortality and heart failure hospitalizations and improved quality of life in 1,050 black patients with heart failure treated with background neurohormonal blockade. Previous trials testing I/H were done in all-male study cohorts, and thus the efficacy of I/H in women was unknown.

METHODS

Baseline characteristics and medications were compared between men and women by I/H and placebo treatment. Survival, time to first heart failure hospitalization, change in quality of life, and event-free survival were compared by gender and treatment.

RESULTS

At baseline, women had lower hemoglobin and creatinine levels; less renal insufficiency; and higher body mass indexes, diabetes prevalence, and systolic blood pressures; but worse quality of life scores. All-cause mortality was lower in women than in men treated with I/H but without significant treatment interaction by gender. The primary composite score, which weighted mortality, first heart failure hospitalization, and change in quality of life at 6 months, was similarly improved by I/H in men and women. First heart failure hospitalization and event-free survival (time to death or first heart failure hospitalization) were similarly improved in both genders.

CONCLUSIONS

Fixed-dose I/H improved heart failure outcomes in both men and women in A-HeFT. The I/H significantly improved the primary composite score and event-free survival as well as reduced the risk of first heart failure hospitalizations similarly in both genders. The I/H had a slightly greater mortality benefit in women, but without a significant treatment interaction by gender.

Authors+Show Affiliations

Department of Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA. taylo135@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17161257

Citation

Taylor, Anne L., et al. "Outcomes By Gender in the African-American Heart Failure Trial." Journal of the American College of Cardiology, vol. 48, no. 11, 2006, pp. 2263-7.
Taylor AL, Lindenfeld J, Ziesche S, et al. Outcomes by gender in the African-American Heart Failure Trial. J Am Coll Cardiol. 2006;48(11):2263-7.
Taylor, A. L., Lindenfeld, J., Ziesche, S., Walsh, M. N., Mitchell, J. E., Adams, K., Tam, S. W., Ofili, E., Sabolinski, M. L., Worcel, M., & Cohn, J. N. (2006). Outcomes by gender in the African-American Heart Failure Trial. Journal of the American College of Cardiology, 48(11), 2263-7.
Taylor AL, et al. Outcomes By Gender in the African-American Heart Failure Trial. J Am Coll Cardiol. 2006 Dec 5;48(11):2263-7. PubMed PMID: 17161257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes by gender in the African-American Heart Failure Trial. AU - Taylor,Anne L, AU - Lindenfeld,JoAnn, AU - Ziesche,Susan, AU - Walsh,Mary Norine, AU - Mitchell,Judith E, AU - Adams,Kirkwood, AU - Tam,S William, AU - Ofili,Elizabeth, AU - Sabolinski,Michael L, AU - Worcel,Manuel, AU - Cohn,Jay N, AU - ,, Y1 - 2006/11/09/ PY - 2006/01/09/received PY - 2006/07/31/revised PY - 2006/08/01/accepted PY - 2006/12/13/pubmed PY - 2007/1/12/medline PY - 2006/12/13/entrez SP - 2263 EP - 7 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 48 IS - 11 N2 - OBJECTIVES: Previous trials testing isosorbide dinitrate/hydralazine (I/H) were performed in all-male study cohorts, and thus the efficacy of I/H in women was unknown; 40% of the A-HeFT (African-American Heart Failure Trial) cohort were women. We therefore compared outcomes by gender and treatment. BACKGROUND: Fixed-dose combined I/H significantly reduced mortality and heart failure hospitalizations and improved quality of life in 1,050 black patients with heart failure treated with background neurohormonal blockade. Previous trials testing I/H were done in all-male study cohorts, and thus the efficacy of I/H in women was unknown. METHODS: Baseline characteristics and medications were compared between men and women by I/H and placebo treatment. Survival, time to first heart failure hospitalization, change in quality of life, and event-free survival were compared by gender and treatment. RESULTS: At baseline, women had lower hemoglobin and creatinine levels; less renal insufficiency; and higher body mass indexes, diabetes prevalence, and systolic blood pressures; but worse quality of life scores. All-cause mortality was lower in women than in men treated with I/H but without significant treatment interaction by gender. The primary composite score, which weighted mortality, first heart failure hospitalization, and change in quality of life at 6 months, was similarly improved by I/H in men and women. First heart failure hospitalization and event-free survival (time to death or first heart failure hospitalization) were similarly improved in both genders. CONCLUSIONS: Fixed-dose I/H improved heart failure outcomes in both men and women in A-HeFT. The I/H significantly improved the primary composite score and event-free survival as well as reduced the risk of first heart failure hospitalizations similarly in both genders. The I/H had a slightly greater mortality benefit in women, but without a significant treatment interaction by gender. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/17161257/Outcomes_by_gender_in_the_African_American_Heart_Failure_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(06)01635-4 DB - PRIME DP - Unbound Medicine ER -