Use Of Sacubitril-valsartan And Associated Outcomes By Race And Ethnicity In Patients With Heart Failure With Reduced Ejection Fraction: Data From Champ-HF

Abstract

Background There are limited data on the use of angiotensin receptor-neprilysin inhibitors (ARNI) in minority demographic populations with heart failure with reduced ejection fraction (HFrEF). We used data from CHAMP-HF to describe ARNI use and associated health status and clinical outcomes across different races and ethnicities. Methods CHAMP-HF was a prospective, observational cohort registry of outpatients in the United States with chronic HFrEF. We compared patients starting ARNI therapy to those not starting ARNI using a propensity-matched analysis. Patients were grouped as Hispanic or Non-Hispanic Black, Non-Hispanic White, or Non-Hispanic Other. Health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ), calculated from pre-match KCCQ score and post-match KCCQ score at least two weeks after the match. Outcomes were analyzed with multivariable models that included race/ethnicity group, ARNI use, and an interaction term between race/ethnicity and ARNI use. Cox proportional hazards models were used for death and HF hospitalization and multiple regression was used for change in KCCQ score. Results 1,516 patients from the CHAMP-HF registry were included, with 758 patients in each group (ARNI and no-ARNI). Changes in KCCQ score before and after ARNI initiation were similar among all race/ethnicity groups studied, including Hispanic and non-Hispanic Black patients. There was no significant interaction between race/ethnicity and ARNI use for change in KCCQ score (Table). In addition, there was no statistically significant interaction between race/ethnicity and ARNI use for HF hospitalization (P=0.82) or all-cause mortality (P=0.92). Conclusion In a large registry of outpatients with HFrEF, the association between ARNI initiation and outcomes, including changes in health status, did not differ by race and ethnicity. These data support the use of ARNI therapy for chronic HFrEF irrespective of race and ethnicity. There are limited data on the use of angiotensin receptor-neprilysin inhibitors (ARNI) in minority demographic populations with heart failure with reduced ejection fraction (HFrEF). We used data from CHAMP-HF to describe ARNI use and associated health status and clinical outcomes across different races and ethnicities. CHAMP-HF was a prospective, observational cohort registry of outpatients in the United States with chronic HFrEF. We compared patients starting ARNI therapy to those not starting ARNI using a propensity-matched analysis. Patients were grouped as Hispanic or Non-Hispanic Black, Non-Hispanic White, or Non-Hispanic Other. Health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ), calculated from pre-match KCCQ score and post-match KCCQ score at least two weeks after the match. Outcomes were analyzed with multivariable models that included race/ethnicity group, ARNI use, and an interaction term between race/ethnicity and ARNI use. Cox proportional hazards models were used for death and HF hospitalization and multiple regression was used for change in KCCQ score. 1,516 patients from the CHAMP-HF registry were included, with 758 patients in each group (ARNI and no-ARNI). Changes in KCCQ score before and after ARNI initiation were similar among all race/ethnicity groups studied, including Hispanic and non-Hispanic Black patients. There was no significant interaction between race/ethnicity and ARNI use for change in KCCQ score (Table). In addition, there was no statistically significant interaction between race/ethnicity and ARNI use for HF hospitalization (P=0.82) or all-cause mortality (P=0.92). In a large registry of outpatients with HFrEF, the association between ARNI initiation and outcomes, including changes in health status, did not differ by race and ethnicity. These data support the use of ARNI therapy for chronic HFrEF irrespective of race and ethnicity.