Race as a Proxy for Genetic Variation in Heart Failure

描述(由申请人提供)：基因变异在观察到的心力衰竭发病率和死亡率的种族差异中的作用尚不清楚。临床试验数据表明，患有心力衰竭的非裔美国人可能受益于肼和硝酸异山梨酯的组合，这些药物以前被认为在所有人群中都无效。这一发现导致了呋喃西林/硝酸异山梨酯组合的开发，该组合可能被批准专门用于患有心力衰竭的非裔美国人。医生对种族和基因变异的看法以及患者的信任可能会影响任何基于种族的疗法的实施。虽然非裔美国人通常不太信任医生，但与种族信任差异相关的潜在因素尚未完全阐明。为了确定患者信任中种族差异的潜在因素，并探索在心力衰竭治疗中使用种族作为遗传变异的替代指标，申请人提出了一项分两个阶段的研究。第一阶段使用定量方法分析非裔美国人和高加索人中患者信任的调查数据。第二阶段使用焦点小组来探索医生对在心力衰竭治疗中使用种族作为遗传变异的代理的看法。

DESCRIPTION (provided by applicant): The role of genetic variation in observed racial differences in heart failure morbidity and mortality are unknown. Clinical trial data suggests that African Americans with heart failure may benefit from a combination of hydralazine/isosorbide dinitrate previously thought to be ineffective in all populations. This discovery has led to the development of a hydralazine/isosorbide dinitrate combination, which may be approved for use exclusively in African Americans with heart failure. Physicians' perceptions on race and genetic variation and patient trust are likely to influence the implementation of any race-based therapies. While African Americans often place less trust in physicians, the underlying factors associated with racial differences in trust have not been fully elucidated. To determine the factors underlying racial differences in patient trust and to explore the use of race as a proxy for genetic variation in the treatment of heart failure, the applicant proposes a two-phase study. Phase I uses quantitative methods to analyze survey data on patient trust among African Americans and Caucasians. Phase II uses focus groups to explore physicians' perceptions of use of race as a proxy for genetic variation in the treatment of heart failure.