Racial differences in outcome and treatment effect in congestive heart failure

• Published in: The American heart journal 2005-11, Vol.150 (5), p.968-976
• Main Authors: Mathew, James, Wittes, Janet, McSherry, Frances, Williford, William, Garg, Rekha, Probstfield, Jeffrey, Yusuf, Salim
• Format: Article
• Language: English
• Subjects: African Americans; African Continental Ancestry Group; Age; Biological and medical sciences; Cardiology. Vascular system; Diabetes; Drug therapy; European Continental Ancestry Group; Female; Heart; Heart failure; Heart Failure - ethnology; Heart Failure - mortality; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hospitalization; Humans; Hypertension; Male; Medical sciences; Methods; Middle Aged; Morbidity; Mortality; Race; Treatment Outcome; Variables; White people
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2005.03.060

In congestive heart failure (CHF), it is unknown whether race affects mortality and whether the effect of treatments differs by race. This study was a post hoc analysis of data from the DIG study that evaluated the effect of digoxin on morbidity and mortality in CHF. Investigators followed 897 black and 6660 white participants for a mean of 37 months. Compared with whites, blacks were younger (60 ± 13 vs 65 ± 11 years). Total mortality was 34.2% in blacks and 33.6% in whites; hospitalization for worsening CHF occurred in 39% of blacks and 28% of whites. Cox regressions with race as the only covariate showed no effect of race on risk for death (relative risk = 1.04, 95% CI 0.93-1.18, P = .49) but an increase in CHF hospitalization in blacks (relative risk = 1.52, 95% CI 1.35-1.70, P = .0001). Multivariate Cox regression showed no difference by race in risk for death or death/hospitalization for CHF and no difference in the effect of digoxin on either end point. Race is not an independent predictor of mortality in CHF. The effect of digoxin on morbidity and mortality in CHF does not differ in blacks and whites.