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Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial.
J Card Fail. 2006 Dec; 12(9):684-8.JC

Abstract

BACKGROUND

Recent data suggest that differences in response to therapy and survival exist between African Americans and Caucasians with heart failure. Whether these differences exist in acute decompensated heart failure (ADHF) is uncertain.

METHODS AND RESULTS

We analyzed data from the OPTIME-CHF (Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure) study, a randomized trial of intravenous milrinone versus placebo in 949 patients hospitalized with ADHF. We evaluated differences in clinical characteristics, outcomes, and response to milrinone therapy in African American patients compared with Caucasians. The primary end point of OPTIME-CHF was days hospitalized for cardiovascular causes or death within 60 days of randomization. Thirty-three percent (n = 310) of patients were African American. African American patients were younger (57 vs. 70 years, P < .0001) and more likely to have non-ischemic cardiomyopathy (74% vs. 36%, P < .0001). In unadjusted analysis, African American patients had a lower 60-day mortality (5% vs. 12%, P = .0004) and tended to have better overall clinical outcomes. After adjustment for baseline differences, however, these differences were no longer significant. We found no differential effect of milrinone therapy by race.

CONCLUSION

African American patients with acute decompensated heart failure present with a different clinical profile than Caucasian patients. Although unadjusted clinical outcomes are better for African Americans presenting with ADHF, these differences diminished after adjustment for baseline characteristics.

Authors+Show Affiliations

Duke Clinical Research Institute, Durham, North Carolina 27705, USA.No 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)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17174228

Citation

Echols, Melvin R., et al. "Racial Differences in the Characteristics of Patients Admitted for Acute Decompensated Heart Failure and Their Relation to Outcomes: Results From the OPTIME-CHF Trial." Journal of Cardiac Failure, vol. 12, no. 9, 2006, pp. 684-8.
Echols MR, Felker GM, Thomas KL, et al. Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial. J Card Fail. 2006;12(9):684-8.
Echols, M. R., Felker, G. M., Thomas, K. L., Pieper, K. S., Garg, J., Cuffe, M. S., Gheorghiade, M., Califf, R. M., & O'Connor, C. M. (2006). Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial. Journal of Cardiac Failure, 12(9), 684-8.
Echols MR, et al. Racial Differences in the Characteristics of Patients Admitted for Acute Decompensated Heart Failure and Their Relation to Outcomes: Results From the OPTIME-CHF Trial. J Card Fail. 2006;12(9):684-8. PubMed PMID: 17174228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial. AU - Echols,Melvin R, AU - Felker,G Michael, AU - Thomas,Kevin L, AU - Pieper,Karen S, AU - Garg,Jyotsna, AU - Cuffe,Michael S, AU - Gheorghiade,Mihai, AU - Califf,Robert M, AU - O'Connor,Christopher M, PY - 2005/11/08/received PY - 2006/08/01/revised PY - 2006/08/01/accepted PY - 2006/12/19/pubmed PY - 2007/1/27/medline PY - 2006/12/19/entrez SP - 684 EP - 8 JF - Journal of cardiac failure JO - J Card Fail VL - 12 IS - 9 N2 - BACKGROUND: Recent data suggest that differences in response to therapy and survival exist between African Americans and Caucasians with heart failure. Whether these differences exist in acute decompensated heart failure (ADHF) is uncertain. METHODS AND RESULTS: We analyzed data from the OPTIME-CHF (Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure) study, a randomized trial of intravenous milrinone versus placebo in 949 patients hospitalized with ADHF. We evaluated differences in clinical characteristics, outcomes, and response to milrinone therapy in African American patients compared with Caucasians. The primary end point of OPTIME-CHF was days hospitalized for cardiovascular causes or death within 60 days of randomization. Thirty-three percent (n = 310) of patients were African American. African American patients were younger (57 vs. 70 years, P < .0001) and more likely to have non-ischemic cardiomyopathy (74% vs. 36%, P < .0001). In unadjusted analysis, African American patients had a lower 60-day mortality (5% vs. 12%, P = .0004) and tended to have better overall clinical outcomes. After adjustment for baseline differences, however, these differences were no longer significant. We found no differential effect of milrinone therapy by race. CONCLUSION: African American patients with acute decompensated heart failure present with a different clinical profile than Caucasian patients. Although unadjusted clinical outcomes are better for African Americans presenting with ADHF, these differences diminished after adjustment for baseline characteristics. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/17174228/Racial_differences_in_the_characteristics_of_patients_admitted_for_acute_decompensated_heart_failure_and_their_relation_to_outcomes:_results_from_the_OPTIME_CHF_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(06)00857-8 DB - PRIME DP - Unbound Medicine ER -