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Representation of Black Patients in RCTs of HFrEF

Am Heart J; ePub 2017 Nov 6; Sullivan, et al

Black patients are only modestly represented among critical randomized clinical trials (RTCs) of individuals with heart failure with reduced ejection fraction (HFrEF) for both pharmacotherapies and implantable cardioverter defibrillators (ICSs), according to a recent review of 25 RTCs. 19 RTCs for pharmacotherapies and 6 (n=9,501) for ICDs were included in the analysis. Researchers found:

  • Among the RTCs, there were 78,816 patients, 4,640 black (5.9%) and the median black participation per trial was 162 patients.
  • Black race was reported in 14 (56.0%) trials and outcomes by race were available for 12 (48.0%) trials.
  • ICD trials enrolled a greater percentage of black patients than pharmacotherapy trials (7.1% vs 5.7%).
  • Patient enrollment among the 25 RTCs increased over time; however, the percentage of black patients decreased.
  • Outcomes varied significantly between black and white patients in 6 studies.


Sullivan LT, Randolph T, Merrill P, et al. Representation of black patients in randomized clinical trials of heart failure with reduced ejection fraction. [Published online ahead of print November 6, 2017]. Am Heart J. doi:10.1016/j.ahj.2017.10.025.