Racial Differences in Diabetic Cardiomyopathy: The ARISE-HF Trial.

BACKGROUND

Diabetic cardiomyopathy (DbCM) increases risk of overt heart failure in individuals with diabetes mellitus. Racial and ethnic differences in DbCM remain unexplored.

OBJECTIVES

The authors sought to identify racial and ethnic differences among individuals with type 2 diabetes mellitus, structural heart disease, and impaired exercise capacity.

METHODS

The ARISE-HF (Aldolase Reductase Inhibitor for Stabilization of Exercise Capacity in Heart Failure) trial is assessing the efficacy of an aldose reductase inhibitor for exercise capacity preservation in 691 persons with DbCM. Baseline characteristics, echocardiographic parameters, and functional capacity were analyzed and stratified by race and ethnicity.

RESULTS

The mean age of the study participants was 67.4 years; 50% were women. Black and Hispanic patients had lower use of diabetes mellitus treatments. Black patients had poorer baseline ventricular function and more impaired global longitudinal strain. Overall, health status was preserved, based on Kansas City Cardiomyopathy Questionnaire scores, but reduced exercise capacity was present as evidenced by reduced Physical Activity Scale for the Elderly (PASE) scores. When stratified by race and ethnicity and compared with the entire cohort, Black patients had poorer health status, more reduced physical activity, and a greater impairment in exercise capacity during cardiopulmonary exercise testing, whereas Hispanic patients also displayed compromised cardiopulmonary exercise testing functional capacity. White patients demonstrated higher physical activity and functional capacity.

CONCLUSIONS

Racial and ethnic differences exist in baseline characteristics of persons affected by DbCM, with Black and Hispanic study participants demonstrating higher risk features. These insights inform the need to address differences in the population with DbCM. (Safety and Efficacy of AT-001 in Patients With Diabetic Cardiomyopathy [ARISE-HF]; NCT04083339).

Informations de copyright

Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The ARISE-HF trial is sponsored by Applied Therapeutics, Inc. Dr Januzzi is funded in part by the Hutter Family Professorship. This work did not receive financial support from external sources. Dr Del Prato has received research support from AstraZeneca and Boehringer Ingelheim; has served as a consultant or on the advisory board/steering committee/executive committee for Abbott, Applied Therapeutics, AstraZeneca, Boehringer Ingelheim, Eli Lilly and Co, Merck & Co, Hengrui Europe Therapeutics, Novartis Pharmaceuticals, Novo Nordisk, and Sanofi; and has received speaker honoraria from AstraZeneca, Boehringer Ingelheim, Eli Lilly and Co, Merck & Co, Novartis Pharmaceuticals, Novo Nordisk, and Sanofi. Dr Ezekowitz has received research support or honoraria from Applied Therapeutics, Boehringer Ingelheim, Novo Nordisk, AstraZeneca, Merck, Bayer, Novartis, Pfizer, Amgen, and Cytokinetics. Dr Lam is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Bayer and Roche Diagnostics; has served as a consultant or on the advisory board/steering committee/executive committee for Abbott, Actelion, Allysta Pharma, Amgen, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma Inc, EchoNous Inc, Impulse Dynamics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc, Radcliffe Group Ltd, Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics, and Us2.ai; and serves as cofounder & nonexecutive director of Us2.ai. Dr Marwick has received research support from General Electric Medical Systems, Philips, Tomtec, Siemens, and AstraZeneca; has received unrestricted educational support from AstraZeneca, Bayer, and Edwards Lifesciences; and serves on the ARISE-HF Steering Committee for Applied Therapeutics. Dr Rosenstock has served on advisory panels for Applied Therapeutics, Boehringer Ingelheim, Eli Lilly, Intarcia, Janssen, Novo Nordisk, Oramed, Sanofi, Hanmi, and Zealand; and has received research support from Applied Therapeutics, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi, Intarcia, Janssen, Lexicon, Merck, Novartis, Novo Nordisk, Oramed, Pfizer, and Sanofi. Dr Tang has served as a consultant for Sequana Medical, Cardiol Therapeutics, Genomics plc, Zehna Therapeutics, Boston Scientific, WhiteSwell, Kiniksa Pharmaceuticals, CardiaTec Biosciences, Intellia Therapeutics, Bristol Myers Squibb, Alleviant Medial, and Alexion; and has received honoraria from Springer Nature, Belvoir Media Group, and American Board of Internal Medicine. Dr Perfetti is the CMO and a stock owner of Applied Therapeutics. Dr Urbinati is an employee and a stock owner of Applied Therapeutics. Dr Januzzi is a Trustee of the American College of Cardiology; is a board member of Imbria Pharmaceuticals; has received research support from Abbott, Applied Therapeutics, Innolife, Novartis Pharmaceuticals, and Roche Diagnostics; has received consulting income from Abbott, Beckman, Bristol Myers, Boehringer Ingelheim, Janssen, Novartis, Pfizer, Merck, Roche Diagnostics, and Siemens; and participates in clinical endpoint committees/data safety monitoring boards for Abbott, AbbVie, Bayer, CVRx, Intercept, Janssen, and Takeda. Dr. Ibrahim has received speaker honoraria from Cytokinetics and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.