Risk of incident heart failure in patients with diabetes and asymptomatic left ventricular systolic dysfunction

Rørth, R., Jhund, P. S. , Mogensen, U. M., Kristensen, S. L., Petrie, M. C. , Køber, L. and McMurray, J. J.V. (2018) Risk of incident heart failure in patients with diabetes and asymptomatic left ventricular systolic dysfunction. Diabetes Care, 41(6), pp. 1285-1291. (doi:10.2337/dc17-2583) (PMID:29626073)

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Abstract

Objective: Although diabetes is well known to be common in prevalent heart failure (HF) and portends a poor prognosis, the role of diabetes in the development of incident HF is less well understood. We studied the role of diabetes in the transition from asymptomatic left ventricular systolic dysfunction (ALVSD) to overt HF in the prevention arm of the Studies of Left Ventricular Dysfunction (SOLVD-P). Research Design and Methods: We examined the development of symptomatic HF, HF hospitalization, and cardiovascular death according to diabetes status at baseline in patients in SOLVD-P. These outcomes were analyzed by using cumulative incidence curves and Cox regression models adjusted for age, sex, and other prognostic factors, including randomized treatment, HF severity, and comorbidity. Results: Of the 4,223 eligible participants, 647 (15%) had diabetes at baseline. Patients with diabetes were older and had a higher average weight, systolic blood pressure, and heart rate. During the median follow-up of 36 months, 861 of the 3,576 patients without diabetes (24%) developed HF compared with 214 of the 647 patients with diabetes (33%). In unadjusted analyses, patients with diabetes had a higher risk of development of HF (hazard ratio 1.53 [95% CI 1.32–1.78]; P < 0.001), HF hospitalization (2.04 [1.65–2.52]; P < 0.0001), and the composite outcome of development of HF or cardiovascular death (1.48 [1.30–1.69]; P < 0.001). The effect of enalapril on outcomes was not modified by diabetes status. Conclusions: In patients with ALVSD, diabetes is associated with an increased risk of developing HF. Development of HF is associated with an increased risk of death irrespective of diabetes status.

Item Type:Articles
Keywords:Internal medicine, endocrinology, diabetes and metabolism, advanced and specialised nursing.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Kristensen, Mr Soren Lund and Jhund, Dr Pardeep and Mogensen, Dr Ulrik and Petrie, Professor Mark and McMurray, Professor John
Authors: Rørth, R., Jhund, P. S., Mogensen, U. M., Kristensen, S. L., Petrie, M. C., Køber, L., and McMurray, J. J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetes Care
Publisher:American Diabetes Association
ISSN:0149-5992
ISSN (Online):1935-5548
Published Online:06 April 2018
Copyright Holders:Copyright © 2018 The American Diabetes Association
First Published:First published in Diabetes Care 41(6): 1285-1291
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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