• Joseph A Franciosa, Anne L Taylor, Jay N Cohn, Clyde W Yancy, Susan Ziesche, Adeoye Olukotun, Elizabeth Ofili, Keith Ferdinand, Joseph Loscalzo, Manuel Worcel, and A-HeFT Investigators.
• Zena and Michael A. Wiener Cardiovascular Institute, Mt. Sinai School of Medicine, New York, New York, USA.
• J. Card. Fail. 2002 Jun 1; 8 (3): 128-35.

BackgroundHydralazine and isosorbide dinitrate combination (H+ISDN), angiotensin-converting enzyme inhibitors, and beta-blockers have improved outcomes in heart failure (HF). Analysis of previous trials has shown that H+ISDN appears especially beneficial in African American patients.Methods And ResultsThe African-American Heart Failure Trial (A-HeFT) is double-blind, placebo-controlled, and includes African American patients with stable New York Heart Association Class III-IV HF on standard therapy. Patients must have prior HF-related events and left ventricular ejection fraction (LVEF) < or = 35% or LVEF <45% with left ventricular internal diastolic dimension >2.9 cm/m(2). Randomization to addition of placebo or BiDil (Nitro Med, Inc., Bedford, MA), a fixed combination of H+ISDN, is stratified for beta-blocker usage. All patients are treated and followed until the last patient entered completes 6 months of follow-up. The primary efficacy endpoint is a composite score including quality of life, death, and hospitalization for HF. At least 600 patients will be randomized; the first was randomized in June 2001.ConclusionsIn addition to providing additional information on BiDil efficacy in HF, A-HeFT is the first HF trial aimed at a selected subgroup of patients and the first to use a new composite HF score as its primary efficacy endpoint.

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