Outcomes by gender in the African-American heart failure trial

被引:38
作者
Taylor, Anne L.
Lindenfeld, JoAnn
Ziesche, Susan
Walsh, Mary Norine
Mitchell, Judith E.
Adams, Kirkwood
Tam, S. William
Ofili, Elizabeth
Sabolinski, Michael L.
Worcel, Manuel
Cohn, Jay N.
机构
[1] Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USA
[2] Univ Colorado, Hlth Sci Ctr, Denver, CO USA
[3] Vet Affairs Med Ctr, Minneapolis, MN USA
[4] Care Grp LLC, Indianapolis, IN USA
[5] Suny Downstate Med Ctr, Brooklyn, NY 11203 USA
[6] Univ N Carolina, Chapel Hill, NC USA
[7] NitroMed Inc, Lexington, MA USA
[8] Morehouse Sch Med, Atlanta, GA 30310 USA
关键词
D O I
10.1016/j.jacc.2006.06.020
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES Previous trials testing isosorbide dinitrate/hydralazine (I/H) were performed in all-mate 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.
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收藏
页码:2263 / 2267
页数:5
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