Abstract 10733: Health Status Outcomes by Race in Patients Treated With Sodium-Glucose Cotransporter 2 Inhibitors: A Pooled Patient-Level Meta-Analysis of CHIEF-HF, DEFINE-HF, and PRESERVED-HF

Introduction Black patients with heart failure (HF) have worse health status (symptoms, function, and quality of life) compared with White patients. Reducing this disparity is a national priority. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) not only improve cardiovascular mortality and hospitalization rates in HF patients regardless of ejection fraction (EF) but also improve patients’ health status. However, because Black patients have not been well represented in global HF outcomes trials, whether the benefits of SGLT2i on health status are consistent in patients with HF regardless of race is not well understood. Methods We combined patient-level data from three US randomized, double-blinded clinical trials of SGLT2i vs. placebo, DEFINE-HF (n=263), PRESERVED-HF (n=324), and CHIEF-HF (n=448). All three trials collected the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and 12-weeks after treatment initiation. We assessed the change in the KCCQ clinical summary score (CSS, which comprises symptoms and physical limitations) by treatment arm in White and Black participants and tested the interaction of treatment by race using multivariable linear regression adjusting for trial and baseline KCCQ scores (as a restricted cubic spline). Results Among 935 participants, 236 (25%) self-identified as Black, and 469 (50.2%) were treated with an SGLT2i. Treatment-related changes in the KCCQ by race are summarized in the Table. Treatment with an SGLT2i vs. placebo resulted in 4.7-point improvement in CCS in Black patients (95% CI 0.74, 8.68; p= 0.02) and 4-point improvement in White patients (95% CI 1.69, 6.29; p=0.0007), with no treatment benefit heterogeneity by race (interaction p-value = 0.76). Conclusions The health status benefits of SGLT2i are consistent in Black and White patients. Therefore, whether improved access to SGLT2i can reduce HF-related health status disparities in Black patients should be tested.