Overview of ARISE-HF Trial Findings

The latest analysis emerging from the ARISE-HF trial has shed illuminating light on the significant racial and ethnic disparities seen in diabetic cardiomyopathy (DbCM). Presented at the American College of Cardiology (ACC) 2025 Annual Scientific Sessions, this secondary analysis dives deep into baseline characteristics and disease progression observed among different racial groups in the trial.

Background on Original ARISE-HF Trial

The original ARISE-HF trial, also showcased at prior ACC events, evaluated the efficacy of AT-001, an aldose reductase inhibitor. Despite hopes for improved exercise capacity, results indicated that AT-001 did not provide significant benefits over placebo treatment.

Key Disparities Observed in the Study

However, the compelling findings from the subsequent analysis revealed alarming trends: Black and Hispanic participants in the placebo cohort showed significantly greater declines in peak VO2, a crucial measure of cardiovascular fitness, in comparison to their White counterparts. Specifically, Black patients exhibited a decline of -0.74 mL/kg/min, while Hispanic patients experienced a drop of -1.67 mL/kg/min, juxtaposed with only a -0.23 mL/kg/min decrease observed in White patients (P = .005). Moreover, Black patients also reported a drastic reduction in their Kansas City Cardiomyopathy Questionnaire scores, indicating an increased symptom burden and diminished quality of life, again more pronounced than in the White demographic.

Impact of AT-001 on Physical Capacity Decline

Even though AT-001 appeared to slow the decline in physical capacity by nearly 50%, this result failed to achieve statistical significance across the diverse racial and ethnic groups involved. Investigators cautioned that these findings accentuate the considerable racial and ethnic disparities in the progression of DbCM, which may be influenced by varying levels of baseline disease severity, existing comorbidities, and wider social determinants of health.

Call for Further Research

Dr. Jose Lopez, the lead investigator from the University of Miami JFK Medical Center, emphasized the need for further research to pinpoint and address these underlying disparities. A tailored approach to optimize treatment strategies for high-risk populations is crucial moving forward.

Conclusion and Future Directions

As we continue to explore the nuances of heart conditions among diverse populations, one thing is clear: understanding these disparities is essential for improving the quality of care and outcomes in diabetic cardiomyopathy. For an in-depth discussion with Dr. Lopez on these findings and their implications for future treatment, stay tuned for our exclusive interview from the ACC.25 conference floor!