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Effect of fixed-dose combined isosorbide dinitrate/hydralazine in elderly patients in the African-American heart failure trial.
J Card Fail. 2012 Aug; 18(8):600-6.JC

Abstract

BACKGROUND

Fixed-dose combined isosorbide dinitrate/hydralazine (FDC I/H) significantly improved outcomes in patients with advanced heart failure (HF) receiving background neurohormonal therapy in the African-American Heart Failure Trial (A-HeFT). In this analysis, we investigated treatment effects by age <65 or ≥65 years.

METHODS AND RESULTS

Time-to-event curves were produced by the Kaplan-Meier method. Hazard ratios were calculated with the Cox proportional hazards model. Baseline characteristics showed that patients ≥65 years old had less hypertensive and more ischemic HF, better quality of life (QoL) scores, higher plasma B-type natriuretic peptide and creatinine levels, and received less background neurohormonal therapy. Kaplan-Meier curves showed that FDC I/H improved mortality and event-free survival in elderly patients. The hazard ratios for mortality, first heart failure hospitalization, and event-free survival (both unadjusted and adjusted for baseline differences), were similar quantitatively and in direction of effect in both age groups.

CONCLUSIONS

In A-HeFT, FDC I/H improved outcomes in HF patients aged <65 or ≥65 years, despite significant baseline differences between these age groups. Patients aged ≥65 years, a group at greater mortality risk, had the greatest survival benefit from FDC I/H.

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Authors+Show Affiliations

Taylor AL
Department of Medicine, Columbia University Medical Center, College of Physicians and Surgeons, New York, New York 10032, USA. ataylor@columbia.edu
Sabolinski ML
No affiliation info available
Tam SW
No affiliation info available
Ziesche S
No affiliation info available
Ghali JK
No affiliation info available
Archambault WT
No affiliation info available
Worcel M
No affiliation info available
Cohn JN
No affiliation info available
A-HeFT Investigators
No affiliation info available

MeSH

African AmericansAge FactorsAgedAgingDouble-Blind MethodDrug Therapy, CombinationFemaleHealth Status IndicatorsHeart FailureHumansHydralazineIsosorbide DinitrateKaplan-Meier EstimateMaleMiddle AgedNitric Oxide DonorsQuality of LifeTimeTreatment OutcomeUnited StatesVasodilator Agents

Pub Type(s)

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

Language

eng

PubMed ID

22858074

Citation

Taylor, Anne L., et al. "Effect of Fixed-dose Combined Isosorbide Dinitrate/hydralazine in Elderly Patients in the African-American Heart Failure Trial." Journal of Cardiac Failure, vol. 18, no. 8, 2012, pp. 600-6.
Taylor AL, Sabolinski ML, Tam SW, et al. Effect of fixed-dose combined isosorbide dinitrate/hydralazine in elderly patients in the African-American heart failure trial. J Card Fail. 2012;18(8):600-6.
Taylor, A. L., Sabolinski, M. L., Tam, S. W., Ziesche, S., Ghali, J. K., Archambault, W. T., Worcel, M., & Cohn, J. N. (2012). Effect of fixed-dose combined isosorbide dinitrate/hydralazine in elderly patients in the African-American heart failure trial. Journal of Cardiac Failure, 18(8), 600-6. https://doi.org/10.1016/j.cardfail.2012.06.526
Taylor AL, et al. Effect of Fixed-dose Combined Isosorbide Dinitrate/hydralazine in Elderly Patients in the African-American Heart Failure Trial. J Card Fail. 2012;18(8):600-6. PubMed PMID: 22858074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of fixed-dose combined isosorbide dinitrate/hydralazine in elderly patients in the African-American heart failure trial. AU - Taylor,Anne L, AU - Sabolinski,Michael L, AU - Tam,S William, AU - Ziesche,Susan, AU - Ghali,Jalal K, AU - Archambault,W Tad, AU - Worcel,Manuel, AU - Cohn,Jay N, AU - ,, PY - 2010/03/22/received PY - 2012/06/08/revised PY - 2012/06/15/accepted PY - 2012/8/4/entrez PY - 2012/8/4/pubmed PY - 2012/12/18/medline SP - 600 EP - 6 JF - Journal of cardiac failure JO - J Card Fail VL - 18 IS - 8 N2 - BACKGROUND: Fixed-dose combined isosorbide dinitrate/hydralazine (FDC I/H) significantly improved outcomes in patients with advanced heart failure (HF) receiving background neurohormonal therapy in the African-American Heart Failure Trial (A-HeFT). In this analysis, we investigated treatment effects by age <65 or ≥65 years. METHODS AND RESULTS: Time-to-event curves were produced by the Kaplan-Meier method. Hazard ratios were calculated with the Cox proportional hazards model. Baseline characteristics showed that patients ≥65 years old had less hypertensive and more ischemic HF, better quality of life (QoL) scores, higher plasma B-type natriuretic peptide and creatinine levels, and received less background neurohormonal therapy. Kaplan-Meier curves showed that FDC I/H improved mortality and event-free survival in elderly patients. The hazard ratios for mortality, first heart failure hospitalization, and event-free survival (both unadjusted and adjusted for baseline differences), were similar quantitatively and in direction of effect in both age groups. CONCLUSIONS: In A-HeFT, FDC I/H improved outcomes in HF patients aged <65 or ≥65 years, despite significant baseline differences between these age groups. Patients aged ≥65 years, a group at greater mortality risk, had the greatest survival benefit from FDC I/H. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/22858074/Effect_of_fixed_dose_combined_isosorbide_dinitrate/hydralazine_in_elderly_patients_in_the_African_American_heart_failure_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(12)00722-1 DB - PRIME DP - Unbound Medicine ER -
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