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American Heart Association

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Final ID: Mo1120

Hispanic/Latino Patients with Heart Failure with Preserved Ejection Fraction: A Participant Level Pooled Analysis of 3 Contemporary Trials

Abstract Body (Do not enter title and authors here): Introduction:
Prior studies have suggested that Hispanic/Latino patients with HFpEF in the US may have lower mortality rates than non-Hispanic/Latinos. However, few contemporary data exist examining the clinical risks faced by Hispanic/Latino patients with HFpEF, especially in global settings.

Methods:
We performed a participant-level pooled analysis of the TOPCAT (Americas region), PARAGON-HF, and DELIVER trials, including participants with symptomatic HF and an LVEF >40% (in DELIVER) or ≥45% (in TOPCAT and PARAGON-HF). Hispanic/Latino ethnicity was self-reported. The risk of the primary endpoint, cardiovascular death or HF hospitalization, was compared among Hispanic/Latino and non-Hispanic/Latino patients using Cox regression models adjusted for relevant clinical covariates, stratified by trial and region of enrollment.

Results:
Of the 12,826 participants, 2,013 (16%) were Hispanic/Latino. 71% of Hispanic/Latino patients were enrolled in Latin America, 19% in North America and 10% in Europe. Hispanic/Latino participants were less likely to have a history of atrial fibrillation (36% vs. 56%), had a higher eGFR, and had better functional status but had similar levels of natriuretic peptides as compared to non-Hispanic patients (Figure 1). During a median follow-up of 2.6 years, Hispanic/Latino participants experienced similar rates of the primary outcome (adj HR 1.12; 95% CI 0.90-1.39; p=0.29) and secondary outcomes as compared to non-Hispanic/Latinos (Table 1 and Figure 1). Findings were similar when including only patients enrolled in the Americas (n=4,728; adj HR 1.05; 95% CI: 0.78-1.41; p=0.77). There were no interactions with age, sex, BMI, or diabetes status.

Conclusions:
Contrary to prior reports, this pooled analysis of HFpEF participants enrolled in 3 contemporary global trials showed that Hispanic/Latino patients experienced similarly heightened risks of adverse cardiovascular outcomes and mortality as non-Hispanic/Latino patients.
  • Pabon, Maria  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Mcmurray, John  ( UNIVERSITY OF GLASGOW , Glasgow , United Kingdom )
  • Solomon, Scott  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Vaduganathan, Muthiah  ( Brigham and Womens Hospital , Boston , Massachusetts , United States )
  • Claggett, Brian  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Fernandez, Marcos  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Makuvire, Tracy  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Desai, Akshay  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Lewis, Eldrin  ( STANFORD UNIVERSITY , Palo Alto , California , United States )
  • Jhund, Pardeep  ( UNIVERSITY OF GLASGOW , Glasgow , United Kingdom )
  • Pfeffer, Marc  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Pitt, Bertram  ( University of Michigan School , Ann Arbor , Michigan , United States )
  • Author Disclosures:
    Maria Pabon: DO NOT have relevant financial relationships | John McMurray: DO have relevant financial relationships ; Research Funding (PI or named investigator):British Heart Foundation, National Institute for Health – National Heart Lung and Blood Institute (NIH-NHLBI), Boehringer Ingelheim, SQ Innovations, Catalyze Group. - Payment to Glasgow University:Active (exists now) ; Other (please indicate in the box next to the company name):KBP Biosciences - My employer, Glasgow University, has been paid by KBP Biosciences for my time spent scientific advisor to company to help guide clinical development in cardio-renal disease, inflammation & infection.:Past (completed) ; Consultant:WIRB-Copernicus Group Clinical Inc. - Data Safety Monitoring Board:Active (exists now) ; Other (please indicate in the box next to the company name):Bayer - My employer, Glasgow University, has been paid by Bayer for my time spent as Steering Committee member for the PANACHE trial using neladenoson bialanate and for the FINEARTS trial with finerenone. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to these trials/drugs.:Active (exists now) ; Other (please indicate in the box next to the company name):Glaxo Smith Kline - My employer, Glasgow University, has been paid by GSK for my time spent as Co-principal investigator and Steering Committee member, respectively, for the Harmony-Outcomes trial (albiglutide) and two trials, ASCEND-D and ASCEND-ND, using daprodustat, and meetings related to these trials. GSK has also paid my travel and accommodation for some of these meetings. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to these trials/drugs.:Active (exists now) ; Other (please indicate in the box next to the company name):Novartis - My employer, Glasgow University, has been paid by Novartis for my time spent as Executive Committee member and then co-principal investigator of ATMOSPHERE, co-principal investigator of the PARADIGM-HF and PARAGON-HF trials and Executive/Steering Committee member for PARADISE-MI, PERSPECTIVE and PARACHUTE-HF trials (with sacubitril/valsartan) and meetings/presentations related to these trials and aliskiren and sacubitril/valsartan. Novartis has also paid my travel and accommodation for some of these meetings. These payments were made through a Consultancy with Glasgow University and I have not received personal payments from Novartis in relation to these trials/drugs.:Active (exists now) ; Other (please indicate in the box next to the company name):Cardurion - My employer, Glasgow University, has been paid by Cardurion for my participation in a company advisory board about development of a PDE 9 inhibitor in heart failure.:Active (exists now) ; Consultant:Global Clinical Trial Partners Ltd. - Director:Active (exists now) ; Consultant:Alynylam Pharmaceuticals, Amgen, AnaCardio, AstraZeneca, Bayer, Berlin Cures, BMS, Cardurion, Cytokinetics, Ionis Pharmaceuticals, Novartis, Regeneron Pharmaceuticals, River 2 Renal Corp.:Active (exists now) ; Other (please indicate in the box next to the company name):Theracos - My employer, Glasgow University, has been paid by Theracos for my time spent as Principal investigator for the BEST trial and meetings related to this trial. Theracos has also paid my travel and accommodation for some of these meetings. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to this trial/this drug.:Past (completed) ; Other (please indicate in the box next to the company name):Amgen - My employer, Glasgow University, has been paid by Amgen for my time spent as Steering Committee member for the ATOMIC-HF, COSMIC-HF and GALACTIC-HF trials and meetings and other activities related to these trials. Amgen has also paid my travel and accommodation for some of these meetings/activities. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to these trials/this drug.:Active (exists now) ; Other (please indicate in the box next to the company name):Cytokinetics - My employer, Glasgow University, has been paid by Cytokinetics for my time spent as Steering Committee member for the ATOMIC-HF, COSMIC-HF and GALACTIC-HF trials and meetings and other activities related to these trials. Cytokinetics has also paid my travel and accommodation for some of these meetings/activities. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to these trials/this drug.:Active (exists now) ; Speaker:Abbott, Alkem Metabolics, Astra Zeneca, Blue Ocean Scientific Solutions Ltd., Boehringer Ingelheim, Canadian Medical and Surgical Knowledge, Emcure Pharmaceuticals Ltd., Eris Lifesciences, European Academy of CME, Hikma Pharmaceuticals, Imagica Health, Intas Pharmaceuticals, J.B. Chemicals & Pharmaceuticals Ltd., Lupin Pharmaceuticals, Medscape/Heart.Org., ProAdWise Communications, Radcliffe Cardiology, Sun Pharmaceuticals, The Corpus, Translation Research Group, Translational Medicine Academy - personal lecture fees:Active (exists now) ; Other (please indicate in the box next to the company name):AstraZeneca - My employer, Glasgow University, has been paid by AstraZeneca (who market dapagliflozin) for my time spent as Principal Investigator of DAPA-HF and Co-principal Investigator of DELIVER and DETERMINE (trials using dapagliflozin) in heart failure and meetings and other activities related to these trials. AstraZeneca has also paid my travel and accommodation for these meetings. These payments were made through a Consultancy with Glasgow University and I have not received personal payments in relation to this trial/this drug.:Active (exists now) | Scott Solomon: DO have relevant financial relationships ; Research Funding (PI or named investigator):Alexion, Alnylam, Applied Therapeutics, AstraZeneca, Bellerophon, Bayer, BMS, Boston Scientific, Cytokinetics, Edgewise, Eidos/BridgeBio, Gossamer, GSK, Ionis, Lilly,NIH/NHLBI, Novartis, NovoNordisk, Respicardia, Sanofi Pasteur, Tenaya, Theracos, US2.AI:Active (exists now) ; Consultant:Abbott, Action, Akros, Alexion, Alnylam, Amgen, Arena, AstraZeneca, Bayer, BMS, Cardior, Cardurion, Corvia, Cytokinetics, GSK, Intellia, Lilly, Novartis, Roche, Theracos, Quantum Genomics, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, Valo:Active (exists now) | Muthiah Vaduganathan: DO have relevant financial relationships ; Researcher:received research grant support, served on advisory boards, or had speaker engagements with American Regent, Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, BMS, Boehringer Ingelheim, Chiesi, Cytokinetics, Lexicon Pharmaceuticals, Merck, Novartis, Novo Nordisk, Pharmacosmos, Relypsa, Roche Diagnostics, Sanofi, and Tricog Health, and participates on clinical trial committees for studies sponsored by AstraZeneca, Galmed, Novartis, Bayer AG, Occlutech, and Impulse Dynamics:Active (exists now) | Brian Claggett: DO have relevant financial relationships ; Consultant:Cardior:Active (exists now) ; Consultant:Eli Lilly:Active (exists now) ; Consultant:CVRx:Past (completed) ; Consultant:Intellia:Active (exists now) ; Consultant:Cytokinetics:Past (completed) ; Consultant:Cardurion:Active (exists now) | Marcos Fernandez: DO NOT have relevant financial relationships | Tracy Makuvire: DO NOT have relevant financial relationships | Akshay Desai: DO have relevant financial relationships ; Research Funding (PI or named investigator):Abbott:Active (exists now) ; Individual Stocks/Stock Options:DTX plus:Past (completed) ; Consultant:Veristat, Zydus:Past (completed) ; Consultant:Medpace, Porter Health, Regeneron, River2Renal, Roche, Verily:Active (exists now) ; Consultant:Merck, Medtronic, Parexel, scPharmaceuticals:Past (completed) ; Consultant:Bayer, Biofourmis, Novartis:Active (exists now) ; Consultant:Avidity, Axon Therapeutics, Boston Scientific, GlaxoSmithKline:Past (completed) ; Consultant:Abbott, Alnylam, AstraZeneca:Active (exists now) ; Research Funding (PI or named investigator):Pfizer:Active (exists now) ; Research Funding (PI or named investigator):Novartis:Active (exists now) ; Research Funding (PI or named investigator):Bayer:Active (exists now) ; Research Funding (PI or named investigator):AstraZeneca:Active (exists now) ; Research Funding (PI or named investigator):Alnylam:Active (exists now) | Eldrin Lewis: DO have relevant financial relationships ; Consultant:Astra Zeneca:Active (exists now) ; Research Funding (PI or named investigator):NIH:Active (exists now) ; Research Funding (PI or named investigator):American Heart Association:Active (exists now) ; Researcher:Idorsia:Active (exists now) ; Consultant:Intellia:Active (exists now) ; Consultant:Merck:Active (exists now) ; Consultant:Akebia:Past (completed) | Pardeep Jhund: DO have relevant financial relationships ; Speaker:Novartis:Past (completed) ; Speaker:ProAdwise Communications:Past (completed) ; Research Funding (PI or named investigator):Roche Diagnostics:Active (exists now) ; Research Funding (PI or named investigator):Analog Devices Inc:Active (exists now) ; Research Funding (PI or named investigator):AstraZeneca:Past (completed) ; Speaker:Intas Pharmaceuticals:Past (completed) ; Speaker:Sun Pharmaceuticals:Past (completed) ; Other (please indicate in the box next to the company name):Novo Nordisk - clinical trial work:Active (exists now) ; Other (please indicate in the box next to the company name):Bayer - clinical trial work:Active (exists now) ; Other (please indicate in the box next to the company name):Astrazeneca - clinical trial work:Active (exists now) ; Other (please indicate in the box next to the company name):Novartis - clinical trial work:Past (completed) ; Speaker:AstraZeneca:Past (completed) ; Advisor:Novartis:Past (completed) | Marc Pfeffer: DO have relevant financial relationships ; Consultant:Alexion, Alnylam, Apnimed, AstraZeneca, Boehringer Ingelheim and Eli Lilly Alliance, DalCor, Intellia, Novartis, and Novo Nordisk. :Active (exists now) ; Individual Stocks/Stock Options:Dal-Cor:Active (exists now) ; Researcher:Lexicon, Novartis:Past (completed) | Bertram Pitt: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

HFPEF Potpourri: Latest Advances and Emerging Topics

Monday, 11/18/2024 , 10:30AM - 11:30AM

Abstract Poster Session

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