1 / 6

Heart Failure Project Groups 3 and 4

Heart Failure Project Groups 3 and 4.

washi
Download Presentation

Heart Failure Project Groups 3 and 4

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Heart Failure ProjectGroups 3 and 4 • Among people who self-identify themselves as non-African Americans, does the addition of isosorbidedinitrate/hydralazine (I/H) added to optimized background treatment for participants with heart failure and reduced ejection fraction reduce all-cause mortality as compared to placebo.

  2. Study Rationale • Data from early trials done in men indicate that I/H may be an effect HF treatment. • A trial done in African Americans was stopped early due to a mortality difference favoring I/H. • Use of I/H is not common. • Morbidity and mortality due to HF remains high. • Comparative data on the efficacy of I/H for non-African Americans in the current era of treatments for HF do not exist.

  3. V-HeFT I: All-cause Mortality in Black and White Patients Black patients White patients 100 100 95 95 HR=0.53 P=0.04 HR=0.88 P=0.47 90 90 85 85 80 80 75 75 70 70 Percent survival Percent survival 65 65 60 60 55 55 50 50 Treatment Group H-I (H) Placebo (P) Treatment Group H-I (H) Placebo (P) 45 45 40 40 35 35 30 30 0 P (N=79) H (N=49) 365 P (N=61) H (N=43) 730 P (N=44) H (N=36) 1095 P (N=29) H (N=28) 1460 P (N=14) H (N=16) 1825 P (N=14) H (N=16) 0 P (N=192) H (N=132) 365 P (N=140) H (N=102) 730 P (N=91) H (N=71) 1095 P (N=55) H (N=42) 1460 P (N=27) H (N=22) 1825 P (N=8) H (N=9) Days since randomization date Days since randomization date Carson P, et al. J Cardiac Fail. 1999;5:178-187.

  4. V-HeFT II: All-cause Mortality in Black and White Patients Black patients White patients 100 100 95 95 HR=1.01 P=NS HR=1.32 P=0.02 90 90 85 85 80 80 75 75 70 70 Percent survival Percent survival 65 65 60 60 55 55 50 50 Treatment Group H-I (H) Enalapril (E) Treatment Group H-I (H) Enalapril (E) 45 45 40 40 35 35 30 30 0 P (N=106) H (N=109) 365 P (N=93) H (N=92) 730 P (N=69) H (N=67) 1095 P (N=47) H (N=49) 1460 P (N=24) H (N=29) 1825 P (N=1) H (N=2) 0 P (N=292) H (N=282) 365 P (N=251) H (N=231) 730 P (N=194) H (N=171) 1095 P (N=123) H (N=105) 1460 P (N=66) H (N=55) 1825 P (N=1) H (N=1) Days since randomization date Days since randomization date Carson P, et al. J Cardiac Fail. 1999;5:178-187.

  5. A-HeFT: 43% Decrease in Mortality 100 Isosorbide dinitrate/hydralazine 95 Survival (%) 90 Placebo HR=0.57 P=0.01 85 0 100 200 300 400 500 600 Days since baseline visit ISDN/HYD518 463 407 359 313 251 13 Placebo 532 466 401 340 285 232 24 Taylor AL, et al. N Engl J Med. 2004;351:2049-2057.

  6. Questions To Consider • Inclusion criteria • Impact of resynchronization therapy on event rates. • Major outcomes to consider • How to conduct the study simply and cost-efficiently (e.g., large, simple trial)

More Related