Trial reportAmerican heart journal2013
Race, exercise training, and outcomes in chronic heart failure: findings from Heart Failure - a Controlled Trial Investigating Outcomes in Exercise TraiNing (HF-ACTION).
Trial report in American heart journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024Pooled it
- Walking for hypertension.The Cochrane database of systematic reviews · 2021Pooled it
- Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis.Journal of the American College of Cardiology · 2019Pooled it
- Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019Pooled it
- Impact of exercise-based cardiac rehabilitation in patients with heart failure (ExTraMATCH II) on mortality and hospitalisation: an individual patient data meta-analysis of randomised trials.European journal of heart failure · 2018Pooled it
- Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis.Heart failure reviews · 2018Pooled it
- Statins and Exercise Training Response in Heart Failure Patients: Insights From HF-ACTION.JACC. Heart failure · 2016Trial
- Variability in Physical Activity Assessed with Accelerometer Is an Independent Predictor of Mortality in CHF Patients.PloS one · 2016Trial
- Psychosocial Factors, Exercise Adherence, and Outcomes in Heart Failure Patients: Insights From Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION).Circulation. Heart failure · 2015Trial
- A randomized controlled exercise training trial on insulin sensitivity in African American men: The ARTIIS study: Major category: study design, statistical design, study protocols.Contemporary clinical trials · 2015Trial
- Clinical implications of chronic heart failure phenotypes defined by cluster analysis.Journal of the American College of Cardiology · 2014Trial
- Associations of an HDL apolipoproteomic index with cardiometabolic risk factors before and after exercise training in the HERITAGE Family Study.Atherosclerosis · 2024Article
- Development a nomogram prognostic model for survival in heart failure patients based on the HF-ACTION data.BMC medical informatics and decision making · 2024Article
- Relationship of Race With Functional and Clinical Outcomes With the REHAB-HF Multidomain Physical Rehabilitation Intervention for Older Patients With Acute Heart Failure.Journal of the American Heart Association · 2023Article
- Sample size requirements for detecting treatment effect heterogeneity in cluster randomized trials.Statistics in medicine · 2020Article
- Impact of baseline covariate imbalance on bias in treatment effect estimation in cluster randomized trials: Race as an example.Contemporary clinical trials · 2020Article
- A National Study of U.S. Emergency Departments: Racial Disparities in Hospitalizations for Heart Failure.American journal of preventive medicine · 2018Article
- Cardiorespiratory Fitness and Atherosclerosis: Recent Data and Future Directions.Current atherosclerosis reports · 2016Review
- "I Just Can't Do It Anymore" Patterns of Physical Activity and Cardiac Rehabilitation in African Americans with Heart Failure: A Mixed Method Study.Healthcare (Basel, Switzerland) · 2015Article
- Racial Differences in Heart Failure Outcomes: Evidence From the Tele-HF Trial (Telemonitoring to Improve Heart Failure Outcomes).JACC. Heart failure · 2015Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
backgroundThe strength of race as an independent predictor of long-term outcomes in a contemporary chronic heart failure (HF) population and its association with exercise training response have not been well established. We aimed to investigate the association between race and outcomes and to explore interactions with exercise training in patients with ambulatory HF.
methodsWe performed an analysis of HF-ACTION, which randomized 2331 patients with HF having an ejection fraction ≤35% to usual care with or without exercise training. We examined characteristics and outcomes (mortality/hospitalization, mortality, and cardiovascular mortality/HF hospitalization) by race using adjusted Cox models and explored an interaction with exercise training.
resultsThere were 749 self-identified black patients (33%). Blacks were younger with significantly more hypertension and diabetes, less ischemic etiology, and lower socioeconomic status versus whites. Blacks had shorter 6-minute walk distance and lower peak VO2 at baseline. Over a median follow-up of 2.5 years, black race was associated with increased risk for all outcomes except mortality. After multivariable adjustment, black race was associated with increased mortality/hospitalization (hazard ratio [HR] 1.16, 95% CI 1.01-1.33) and cardiovascular mortality/HF hospitalization (HR 1.46, 95% CI 1.20-1.77). The hazard associated with black race was largely caused by increased HF hospitalization (HR 1.58, 95% CI 1.27-1.96), given similar cardiovascular mortality. There was no interaction between race and exercise training on outcomes (P > .5).
conclusionsBlack race in patients with chronic HF was associated with increased prevalence of modifiable risk factors, lower exercise performance, and increased HF hospitalization, but not increased mortality or a differential response to exercise training.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.