Impact of Race and Genetic Factors on Beta Blocker Effectiveness in HF

Heart Failure (HF) continues to be an enormous public health problem, despite the many advances in its pharmacotherapy over the past 25 years. The availability of multiple therapeutic options for HF requires individualization of therapy. However, there are currently insufficient tools to guide the optimal selection of therapy. The expansion of human genomic information has led to exciting new opportunities to improve the selection of drug therapy. In order to evaluate whether genetic variation impacts outcomes and drug response in heart failure, we performed a cohort study of patients with heart failure. Our overall plan was to recruit patients who have heart failure and receive treatment through HAP-HFMG. This allowed us to collect clinical outcomes, and quantify medication adherence via electronic pharmacy claims data. We collected whole blood samples for genetic analysis. We then tested whether genetic variants can predict patient outcomes (survival) in the context of their medical therapy (drug exposure). The primary medications of interest were beta blockers. Outcomes were modeled overall, accounting for the amount of exposure to the agent, and adjusting for baseline characteristics.]]>
Inclusion: >=18 years of age Ejection fraction <50% Has HAP insurance Meets Framingham Criteria for Heart Failure Exclusion: <18 years of age Had a heart transplant On dialysis End Stage Renal Disease Currently receiving chemotherapy or radiation treatments Ejection fraction >=50% No HAP insurance ]]>
1,117 people met the inclusion criteria and were enrolled in the study, which included a questionnaire, blood draw, 6 minute walk test, optional cardiopulmonary exercise test, and electronic health data abstraction.]]>