Race and the Response to Adrenergic Blockade with Carvedilol in Patients with Chronic Heart Failure
Key result
Carvedilol reduced the risk of death or hospitalization by 48% in black patients and 30% in nonblack patients, with no significant interaction between race and treatment (P>0.05).
Why the study?
Does carvedilol reduce death or hospitalization similarly in black and nonblack patients with chronic heart failure?
Population
1,094 patients with chronic heart failure in the U.S.
Comparison
Carvedilol 6.25 to 50 mg twice daily for up to… vs Placebo
Design
RCT, randomly assigned
Follow-up
up to 15 months
Authors
Discussion
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Implication
Supports carvedilol use in black patients with chronic HF; confirms consistent benefit without race interaction.
Key Points
- This research aims to determine if race affects the response to carvedilol in chronic heart failure patients.
- Randomized trial involving 217 black and 877 nonblack patients with chronic heart failure.
- Patients received placebo or carvedilol (6.25 to 50 mg twice daily) for up to 15 months.
- Comparative analysis was performed on ejection fraction, clinical status, and major clinical events.
- Carvedilol reduced the risk of death or hospitalization by 48% in black patients and 30% in nonblack patients.
- Worsening heart failure risk dropped by 54% for black patients and 51% for nonblack patients.
- No significant interaction between race and treatment response was found (P>0.05).
Study Design
Type
RCT (n=1,094)
Randomization
Randomized
Multicenter
Yes
Structured PICO
Does carvedilol reduce death or hospitalization similarly in black and nonblack patients with chronic heart failure?
P
Population
1,094 patients (217 black and 877 nonblack) with chronic heart failure (NYHA class II, III, or IV and LVEF ≤0.35) in the U.S.
I
Intervention
Carvedilol 6.25 to 50 mg twice daily for up to 15 months
C
Comparator
Placebo
O
Outcome
Death from any cause or hospitalization for any reason; worsening heart failure (heart failure leading to death, hospitalization, or a sustained increase in medication)composite
Main Result
Effect estimate: Ratio of relative risks 0.74 (95% CI 0.42 to 1.34)
p-value: p=>0.05
Carvedilol provides significant and similar clinical benefits in both black and nonblack patients with chronic heart failure.
Limitations
- Retrospective comparison between racial groups
Cite This Study
Yancy et al. (2001) conducted an RCT in Chronic heart failure (n=1,094). Carvedilol vs. Placebo was evaluated on Death from any cause or hospitalization for any reason (Ratio of relative risks 0.74, 95% CI 0.42 to 1.34, p=>0.05). Carvedilol reduced the risk of death or hospitalization by 48% in black patients and 30% in nonblack patients, with no significant interaction between race and treatment (P>0.05).