A-HeFT研究和PEACE研究（PPT 20页）.ppt

African-American Heart Failure Trial (A-HeFT) A-HeFT design Randomized 1050 men and women who classified themselves as African American Patients had NYHA class 3-4 HF and reduced LV function Received a fixed-dose combination of isosorbide dinitrate-hydralazine or placebo A-HeFT halted early The trial was terminated before the planned 1100 patients had been randomized Significant mortality increase observed in the placebo group There was a 43% reduction in mortality in the group given isosorbide dinitrate plus hydralazine Outcomes of the primary composite end point and its components A-HeFT A magnificent effort. This trial will set a lot of precedents. A-HeFT A stepping stone to identifying what is the genomic basis for this extraordinary benefit. Should we be prescribing these to all black patients with heart failure today? How to apply the results This combination should be added to existing treatments in African Americans with heart failure It is premature to take this action in non-African Americans A-HeFT Its a very interesting trial—its one of a kind. I dont know if theres ever been a cardiovascular medical trial like this one. I would certainly give it two thumbs up for identifying a very important life-saving effect. A-HeFT I give it two thumbs up too for all of the reasons that you just gave. Prevention of Events with Angiotensin-Converting Enzyme Inhibition (PEACE)  PEACE design Would patients with stable coronary artery disease but normal or slightly reduced LVF derive benefit from the addition of ACE inhibitors to conventional therapy? Randomized, double-blind, placebo-controlled study of 8290 patients Patients received either trandolapril 4 mg/day or placebo Findings The incidence of the primary end point—a composite of cardiovascular mortality, nonfatal MI, and coronary revascularization—was nearly identical in the two study arms After an average follow-up of 4.8 years, no subgroup benefited from ACE-inhibitor therapy Incidenc