PURPOSE: Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been established as a mainstay of heart failure treatment. Current data are limited and conflicting regarding the consistency of ACE/ARB benefit across race groups in heart failure. This study aims to clarify this point. METHODS: This was a retrospective study of insured patients with a documented ejection fraction of less than 50%, hospitalized for heart failure between January 2000 and June 2008. Pharmacy claims data were used to estimate ACE/ARB exposure over 6-month rolling windows. The association between ACE/ARB exposure and all-cause hospitalization or death was assessed by proportional hazards regression, with adjustment for baseline covariates and β-blocker exposure. Further analyses were stratified by race, and included an ACE/ARB × Race interaction term. RESULTS: A total of 1095 patients met inclusion criteria (619 African-American individuals). Median follow-up was 2.1 years. In adjusted models, ACE/ARB exposure was associated with lower risk of death or hospitalization in both groups (African-Americans hazard ratio 0.47, P < 0.001; whites hazard ratio 0.55, P < 0.001). A formal test for interaction was consistent with similar effects in each group (P = 0.861, β = 0.04). CONCLUSION: ACE/ARB exposure was equally associated with a protective effect in preventing death or rehospitalization among heart failure patients with systolic dysfunction in both African-American patients and whites.
PURPOSE:Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been established as a mainstay of heart failure treatment. Current data are limited and conflicting regarding the consistency of ACE/ARB benefit across race groups in heart failure. This study aims to clarify this point. METHODS: This was a retrospective study of insured patients with a documented ejection fraction of less than 50%, hospitalized for heart failure between January 2000 and June 2008. Pharmacy claims data were used to estimate ACE/ARB exposure over 6-month rolling windows. The association between ACE/ARB exposure and all-cause hospitalization or death was assessed by proportional hazards regression, with adjustment for baseline covariates and β-blocker exposure. Further analyses were stratified by race, and included an ACE/ARB × Race interaction term. RESULTS: A total of 1095 patients met inclusion criteria (619 African-American individuals). Median follow-up was 2.1 years. In adjusted models, ACE/ARB exposure was associated with lower risk of death or hospitalization in both groups (African-Americans hazard ratio 0.47, P < 0.001; whites hazard ratio 0.55, P < 0.001). A formal test for interaction was consistent with similar effects in each group (P = 0.861, β = 0.04). CONCLUSION:ACE/ARB exposure was equally associated with a protective effect in preventing death or rehospitalization among heart failurepatients with systolic dysfunction in both African-American patients and whites.
Authors: Sharon Ann Hunt; William T Abraham; Marshall H Chin; Arthur M Feldman; Gary S Francis; Theodore G Ganiats; Mariell Jessup; Marvin A Konstam; Donna M Mancini; Keith Michl; John A Oates; Peter S Rahko; Marc A Silver; Lynne Warner Stevenson; Clyde W Yancy Journal: Circulation Date: 2009-03-26 Impact factor: 29.690
Authors: Bradi B Granger; Karl Swedberg; Inger Ekman; Christopher B Granger; Bertil Olofsson; John J V McMurray; Salim Yusuf; Eric L Michelson; Marc A Pfeffer Journal: Lancet Date: 2005-12-10 Impact factor: 79.321
Authors: JoAnn Lindenfeld; Nancy M Albert; John P Boehmer; Sean P Collins; Justin A Ezekowitz; Michael M Givertz; Stuart D Katz; Marc Klapholz; Debra K Moser; Joseph G Rogers; Randall C Starling; William G Stevenson; W H Wilson Tang; John R Teerlink; Mary N Walsh Journal: J Card Fail Date: 2010-06 Impact factor: 5.712
Authors: James J Yang; Esteban G Burchard; Shweta Choudhry; Christine C Johnson; Dennis R Ownby; David Favro; Justin Chen; Matthew Akana; Connie Ha; Pui-Yan Kwok; Richard Krajenta; Suzanne L Havstad; Christine L Joseph; Max A Seibold; Mark D Shriver; L Keoki Williams Journal: J Allergy Clin Immunol Date: 2008-10 Impact factor: 10.793
Authors: Jasmine A Luzum; Ozioma Edokobi; Michael P Dorsch; Edward Peterson; Bin Liu; Hongsheng Gui; L Keoki Williams; David E Lanfear Journal: J Card Fail Date: 2021-08-21 Impact factor: 6.592