The DANish randomized, double-blind, placebo controlled trial in patients with chronic HEART failure (DANHEART): A 2 × 2 factorial trial of hydralazine-isosorbide dinitrate in patients with chronic heart failure (H-HeFT) and metformin in patients with chronic heart failure and diabetes or prediabetes (Met-HeFT)

Am Heart J. 2021 Jan:231:137-146. doi: 10.1016/j.ahj.2020.09.020. Epub 2020 Oct 9.

Abstract

Objectives: The DANHEART trial is a multicenter, randomized (1:1), parallel-group, double-blind, placebo-controlled study in chronic heart failure patients with reduced ejection fraction (HFrEF). This investigator driven study will include 1500 HFrEF patients and test in a 2 × 2 factorial design: 1) if hydralazine-isosorbide dinitrate reduces the incidence of death and hospitalization with worsening heart failure vs. placebo (H-HeFT) and 2) if metformin reduces the incidence of death, worsening heart failure, acute myocardial infarction, and stroke vs. placebo in patients with diabetes or prediabetes (Met-HeFT).

Methods: Symptomatic, optimally treated HFrEF patients with LVEF ≤40% are randomized to active vs. placebo treatment. Patients can be randomized in either both H-HeFT and Met-HeFT or to only one of these study arms. In this event-driven study, it is anticipated that 1300 patients should be included in H-HeFT and 1100 in Met-HeFT and followed for an average of 4 years.

Results: As of May 2020, 296 patients have been randomized at 20 centers in Denmark.

Conclusion: The H-HeFT and Met-HeFT studies will yield new knowledge about the potential benefit and safety of 2 commonly prescribed drugs with limited randomized data in patients with HFrEF.

Trial registration: ClinicalTrials.gov NCT03514108.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Aged
  • Chronic Disease
  • Denmark
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / mortality
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Heart Failure* / drug therapy
  • Heart Failure* / mortality
  • Hospitalization
  • Humans
  • Hydralazine* / therapeutic use
  • Hypoglycemic Agents* / therapeutic use
  • Isosorbide Dinitrate* / therapeutic use
  • Male
  • Metformin* / therapeutic use
  • Multicenter Studies as Topic
  • Myocardial Infarction / prevention & control
  • Placebos / therapeutic use
  • Prediabetic State / drug therapy
  • Prediabetic State / mortality
  • Randomized Controlled Trials as Topic
  • Stroke / prevention & control
  • Stroke Volume

Substances

  • Drug Combinations
  • Hydralazine
  • Hypoglycemic Agents
  • Isosorbide Dinitrate
  • isosorbide-hydralazine combination
  • Metformin
  • Placebos

Associated data

  • ClinicalTrials.gov/NCT03514108