Effect of fixed-dose combined isosorbide dinitrate/hydralazine in elderly patients in the african-american heart failure trial

Anne L. Taylor, Michael L. Sabolinski, S. William Tam, Susan Ziesche, Jalal K. Ghali, W. Tad Archambault, Manuel Worcel, Jay N. Cohn

Research output: Contribution to journalArticle

15 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)600-606
Number of pages7
JournalJournal of cardiac failure
Volume18
Issue number8
DOIs
StatePublished - Aug 1 2012

Keywords

  • Heart failure
  • elderly subjects

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