Evidence map›Paper›PMID 26867758›Full record

Observational studyCirculation. Heart failure2016

Clinical Effectiveness of Hydralazine-Isosorbide Dinitrate Therapy in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Get With The Guidelines-Heart Failure Registry.

Prateeti Khazanie, Li Liang, Lesley H Curtis, Javed Butler, Zubin J Eapen, Paul A Heidenreich, Deepak L Bhatt, Eric D Peterson, Clyde W Yancy, Gregg C Fonarow and 1 more

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 38 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Cardiologists' Perspectives on BiDil and the Use of Race in Drug Prescribing.Journal of racial and ethnic health disparities · 2022
    Article
  5. Article
  6. Article
  7. Review
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  10. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Prateeti KhazanieFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Li LiangFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Lesley H CurtisFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Javed ButlerFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Zubin J EapenFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Paul A HeidenreichFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Deepak L BhattFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Eric D PetersonFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Clyde W YancyFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Gregg C FonarowFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.).
Adrian F HernandezFrom the Duke Clinical Research Institute (P.K., L.L., L.H.C., Z.J.E., E.D.P., A.F.H.) and Department of Medicine (P.K., L.H.C., Z.J.E., E.D.P., A.F.H.), Duke University School of Medicine, Durham, NC; Department of Medicine, Emory University, Atlanta, GA (J.B.); VA Palo Alto Healthcare System, CA (P.A.H.); Heart and Vascular Center and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.); Department of Medicine, Northwestern University, Chicago, IL (C.W.Y.); and Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles (G.C.F.). adrian.hernandez@duke.edu.
Emory University · USUniversity of California, Los Angeles · USNorthwestern University · USBrigham and Women's Hospital · USHarvard University · USVA Palo Alto Health Care System · US

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
Using Data to Drive Change in National CV Care: The Duke CERTSU19HS021092 · AHRQ · DUKE UNIVERSITY · PI PETERSON, ERIC DAVID · 2011 to 2015
$4.2M
AHRQ HHS U19 HS021092AHRQ HHS U19HS021092NHLBI NIH HHS T32 HL069749NHLBI NIH HHS T32HL069749
6 · The paper itself

Abstract

backgroundIn clinical trials, hydralazine-isosorbide dinitrate (H-ISDN) for heart failure with reduced ejection fraction reduced morbidity and mortality among black patients and patients with intolerance to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The effectiveness of H-ISDN in clinical practice is unknown. METHODS AND

resultsUsing data from a clinical registry linked with Medicare claims, we examined the use and outcomes of H-ISDN between 2005 and 2011 among older patients hospitalized with heart failure and reduced ejection fraction. We adjusted for demographic and clinical characteristics using Cox proportional hazards models and inverse probability weighting. Among 4663 eligible patients, 22.7% of black patients and 18.2% of patients not on an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker were newly prescribed H-ISDN therapy at discharge. By 3 years, the cumulative incidence rates of mortality and readmission were similar between treated and untreated patients. After multivariable adjustment, 3-year outcomes remained similar for mortality [black patients: hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.75-1.13; other patients: HR, 0.93; 95% CI, 0.79-1.09], all-cause readmission (black patients: HR, 0.98; 95% CI, 0.84-1.13; other patients: HR, 1.02; 95% CI, 0.90-1.17), and cardiovascular readmission (black patients: HR, 0.99; 95% CI, 0.82-1.19; other patients: HR, 0.94; 95% CI, 0.81-1.09). A post hoc analysis of Medicare Part D data revealed low postdischarge adherence to therapy.

conclusionsGuideline-recommended initiation of H-ISDN therapy at hospital discharge was uncommon, and adherence was low. For both black patients and patients of other races, there were no differences in outcomes between those treated and untreated at discharge.

Indexed as

AgedAged, 80 and overChi-Square DistributionDisease ProgressionDrug CombinationsFemaleGuideline AdherenceHeart FailureHumansHydralazineIsosorbide DinitrateKaplan-Meier EstimateLogistic ModelsMaleMedicare Part DPatient DischargeDrug CombinationsHydralazineIsosorbide Dinitrateisosorbide-hydralazine combinationcardiomyopathiesheart failuremortalitypharmacologyregistriessurvival

Identifiers

PMID26867758
PMCPMC4755330
OpenAlexW2269847225

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.