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Racial outcomes in patients with diabetic cardiomyopathy treated with an aldose reductase inhibitor: the ARISE-HF

Jose L Batista1, Yuxi Liu2, Javed Butler3,4

  • 1Section of Clinical Cardiac Electrophysiology, University of Michigan Samuel and Jean Frankel Cardiovascular Center, Ann Arbor, Michigan, USA josebati@med.umich.edu.

Open Heart
|July 31, 2026
PubMed

Insights

Black and Hispanic individuals with diabetic cardiomyopathy (DbCM) show faster disease progression. AT-001 did not significantly alter peak oxygen uptake (peak VO2) changes across racial groups.

Area of Science:

  • Cardiology
  • Diabetology
  • Pharmacology

Background:

  • Racial and ethnic disparities exist in diabetic cardiomyopathy (DbCM), with Black and Hispanic individuals experiencing poorer health outcomes.
  • The impact of these disparities on the natural progression of DbCM remains under investigation.
  • Understanding these differences is crucial for developing targeted therapeutic strategies.

Purpose of the Study:

  • To evaluate disease progression in individuals diagnosed with diabetic cardiomyopathy (DbCM).
  • To assess potential racial differences in the response to the investigational drug AT-001.
  • To analyze the impact of race and ethnicity on key clinical outcomes in DbCM.

Main Methods:

  • A randomized controlled trial involving 625 participants with DbCM.
  • Participants were assigned to receive either placebo or AT-001 for 15 months.
  • Primary outcome: change in peak oxygen uptake (peak VO2); Secondary outcomes: Kansas City Cardiomyopathy Questionnaire (KCCQ) and Physical Activity Scale for the Elderly scores. Analyses were stratified by race (Black, Hispanic, White).

Main Results:

  • Placebo recipients: Black and Hispanic participants showed significantly greater declines in peak VO2 compared to White participants.
  • AT-001 treatment: A trend towards slower peak VO2 decline was observed in Black and Hispanic participants, though not statistically significant.
  • Quality of Life: Black participants receiving placebo experienced the most substantial declines in Kansas City Cardiomyopathy Questionnaire (KCCQ) scores.

Conclusions:

  • Black and Hispanic individuals with DbCM exhibit accelerated disease progression, marked by pronounced functional and quality-of-life impairments.
  • The investigational drug AT-001 did not demonstrate statistically significant effects on peak VO2 changes, with similar trends observed across racial and ethnic groups.
  • Further research is warranted to explore effective interventions for mitigating racial disparities in diabetic cardiomyopathy progression.
Abstract

Keywords:
CARDIOMYOPATHYDiabetes MellitusHEART FAILURE

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