Abstract 18941: Vasodilator Use Guided by Wireless Pulmonary Artery Hemodynamic Monitoring Reduces Heart Failure Hospitalizations in Both African American and Non-African American Heart Failure Patients: Results from the CHAMPION Trial

Abstract

Introduction: It is unknown whether benefits produced by nitrates and hydralazine (HDZ) in African Americans (AA) also occur in non-African American (non-AA) patients. The CHAMPION Trial showed that, compared to usual care (UC) patients, those managed according to wirelessly measured pulmonary artery pressures (w-PAP) plus UC had a significant reduction in heart failure (HF) hospitalizations over 6 months. The current analysis evaluated pattern of use and effects of nitrates and HDZ in AA and non-AA CHAMPION trial subjects to determine if non-AA patients receiving these vasodilators according to w-PAP will have benefits similar to those occurring in non-AA. Methods: Retrospective comparison of changes in use of nitrates and HDZ in AA and non-AA subjects randomized in the CHAMPION trial and evaluation of the effects of these therapeutic changes on HF hospitalization rates. Results: Of 424 non-AA patients, 202 were assigned to w-PAP and 222 to UC. Of 126 AA, 68 were assigned to w-PAP and 58 to UC. Baseline nitrate and HDZ use was similar between w-PAP and UC for both non-AA and AA groups. At 6 months nitrate use increased more in the w-PAP than UC group in both non-AA [90 (44.6%) vs. 48 (21.6%); p< 0.0001] and AA [23 (33.8%) vs. 17 (29.3%); p=ns due to small sample size]. At 6 months HDZ use increased more in the w-PAP than UC group in both non-AA [39 (19.3%) vs. 27 (12.2%); p< 0.0452] and AA [22 (32.4%) vs. 15 (25.9%); p=ns due to small sample size] . Within the non-AA population nitrate dose increased at 6 months more in the w-PAP than in the UC group (20.43 mg vs. 4.21 mg; p= 0.05). HF hospitalization rates were significantly lower in w-PAP than UC subjects both within the non-AA (0.31 vs. 0.43 p = 0.0007) and the AA population (0.33 vs. 0.45 p=ns due to small sample size) and the magnitude of reduction in HF hospitalization was similar for non-AA and AA subjects. Conclusions: Greater utilization of nitrates and HDZ in HF patients managed with w-PAP produces significant and similar reductions in HF hospitalizations in non-AA and AA HF patients.