Fixed-Dose Combo for Heart Failure Reduces Readmissions, Improves QoL
the MPR take:
Few studies have examined the effect of heart failure (HF) therapies on all hospitalizations, including recurrences. Focusing only on first admission may not be an accurate representation of a treatment’s effect on overall burden of admissions, argues a new study in Circulation: Heart Failure. Using data from the African-American Heart Failure Trial (A-HeFT), 1,050 self-identified black patients with moderate to severe HF were randomized to receive either a fixed-dose combination of isosorbide dinitrate and hydralazine (FDC-I/H) or placebo with a follow-up of a median of 450 days. The addition of FDC-I/H to guideline-based background therapy that included beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and aldosterone blockers significantly reduced all-cause mortality and improved the subjects’ quality of life. FDC-I/H was also associated with a substantial reduction in the first and recurrent HF hospitalizations and in total all-cause hospitalizations. This not only reduced the total burden of costly and distressing hospitalizations, but also reduced the burden to the patient. The authors encourage the inclusion of recurrent admissions in future research to expand upon this neglected area of cardiovascular research.
Background: Fixed-dose combination of isosorbide dinitrate and hydralazine (FDC-I/H) reduced mortality by 43% and death or first hospitalization for heart failure (HF) by 37% in the African-American Heart Failure Trial (A-HeFT). Reduction in mortality makes it difficult to determine the effect ...
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