Diabetes Influences Outcomes in Chronic Heart Failure
Elevated HbA1c levels were associated with 1-year all-cause mortality and cardiovascular death in patients with chronic heart failure (CHF), according to the results of a new study.
The study included a multinational cohort of 9428 outpatients with CHF who were enrolled in the European Society of Cardiology and Heart Failure Association Long-Term Registry. Of the 9428 patients, 3440 (36.5%) had diabetes.
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Over the course of 1 year, researchers found that patients with diabetes had higher cumulative rates for all-cause mortality (9.4% vs 7.2%), cardiovascular death (4.8% vs 3.8%), and heart failure hospitalization (13.8% vs 9.3%) compared with patients without diabetes. Diabetes was found to be independently associated with higher all-cause mortality and cardiovascular death after researchers adjusted for age, sex, body mass index, smoking status, systolic blood pressure, estimated glomerular filtration rate, hemoglobin, heart failure etiology, left ventricular ejection fraction, hypertension, statin use, prior stroke, and chronic obstructive pulmonary disease.
In the 2567 patients with available HbA1c levels, researchers found a significant independent association between increasing HbA1c levels and all-cause and cardiovascular mortality.
“The presence of diabetes markedly increases the risk of 1-year adverse clinical outcomes in outpatients with CHF independent of multiple common risk factors,” the researchers concluded. “More effective and personalized treatment for diabetes should be considered in this particularly high-risk patient population.”
—Melissa Weiss
Reference:
Dauriz M, Targher G, Laroche C, et al. Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure: results from the ESC-HFA Heart Failure Long-Term Registry [published online April 20, 2017]. Diabetes. doi:https://doi.org/10.2337/dc16-2016.