African-American Heart Failure Trial (A-HeFT), treatment with fixed-dose combined isosorbide dinitrate / hydralazine

Last reviewed 01/2018

• in the African-American Heart Failure Trial (A-HeFT), treatment with fixed-dose combined isosorbide dinitrate/hydralazine (FDC I/H) added to neurohormonal blockade in patients with advanced HF resulted in
  • a further 43% incremental reduction in mortality
  • a 39% reduction in heart failure hospitalizations
  • a 37% improvement in event-free survival, and significant improvement in quality of life (QoL)

Hydralazine-isosorbide dinitrate therapy is recommended for African American patients with moderate to severe heart failure with reduced ejection fraction (<40%) (HFrEF) (3)

Reference:

• Taylor AL et al. African-American Heart Failure Trial Investigators et al. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. NEJM (2004); 351:049-2057
• Taylor AL et al. African-American Heart Failure Trial Investigators et al. Early and sustained benefit on event-free survival and heart failure hospitalization from fixed-dose combination of isosorbide dinitrate/hydralazine. Circulation (2007);115:1747-1753.
• Golwala HB. Use of hydralazine-isosorbide dinitrate combination in African American and other race/ethnic group patients with heart failure and reduced left ventricular ejection fraction.J Am Heart Assoc. 2013;21;2(4):