Abstract 4144261: Hispanic/Latino Patients with Heart Failure with Preserved Ejection Fraction: A Participant Level Pooled Analysis of 3 Contemporary Trials

Abstract

Introduction: Prior studies have suggested that Hispanic/Latino patients with HFpEF in the US may have lower mortality rates than non-Hispanic/Latinos. However, few contemporary data exist examining the clinical risks faced by Hispanic/Latino patients with HFpEF, especially in global settings. Methods: We performed a participant-level pooled analysis of the TOPCAT (Americas region), PARAGON-HF, and DELIVER trials, including participants with symptomatic HF and an LVEF >40% (in DELIVER) or ≥45% (in TOPCAT and PARAGON-HF). Hispanic/Latino ethnicity was self-reported. The risk of the primary endpoint, cardiovascular death or HF hospitalization, was compared among Hispanic/Latino and non-Hispanic/Latino patients using Cox regression models adjusted for relevant clinical covariates, stratified by trial and region of enrollment. Results: Of the 12,826 participants, 2,013 (16%) were Hispanic/Latino. 71% of Hispanic/Latino patients were enrolled in Latin America, 19% in North America and 10% in Europe. Hispanic/Latino participants were less likely to have a history of atrial fibrillation (36% vs. 56%), had a higher eGFR, and had better functional status but had similar levels of natriuretic peptides as compared to non-Hispanic patients (Figure 1). During a median follow-up of 2.6 years, Hispanic/Latino participants experienced similar rates of the primary outcome (adj HR 1.12; 95% CI 0.90-1.39; p=0.29) and secondary outcomes as compared to non-Hispanic/Latinos ( Table 1 and Figure 1 ). Findings were similar when including only patients enrolled in the Americas (n=4,728; adj HR 1.05; 95% CI: 0.78-1.41; p=0.77). There were no interactions with age, sex, BMI, or diabetes status. Conclusions: Contrary to prior reports, this pooled analysis of HFpEF participants enrolled in 3 contemporary global trials showed that Hispanic/Latino patients experienced similarly heightened risks of adverse cardiovascular outcomes and mortality as non-Hispanic/Latino patients.