2004 -0.1 3.1 A-HEFT TRIAL Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure Inclusion criteria: patients self-identified as 1,050 black (of African descent) with NYHA class III-IV patients HF ≥3 months on standard therapy, including ACEI/ARBs, ẞ-blockers, spironolactone, diuretics 6.2 double-blinded, parallel-group, randomized, placebo-controlled Objective: Among self-identified black patients with HFREF, does the combination of isosorbide dinitrate and hydralazine improve survival compared to placebo? ISDN/ hydralazine (n=518) VS PRIMARY OUTCOME Primary composite score (calculated from all-cause mortality, HF hospitalizations, and quality of life P=0.01 SECONDARY OUTCOME Adverse event: Severe HF exacerbation P=0.005 Placebo (n=532) All-cause mortality % RR 0.61; P=0.02 Anne L. Taylor, et al. N Engl J Med 2004; 351:2049-2057 -0.5 7.0 10.2 Conclusion: The addition of a fixed dose of isosorbide dinitrate plus hydralazine to standard therapy for heart failure including neurohormonal blockers is efficacious and increases survival among black patients with advanced heart failure.