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Prognostic impact of diabetes mellitus in patients with heart failure and preserved ejection fraction: a prospective five-year study.
Heart. 2008 Nov; 94(11):1450-5.H

Abstract

OBJECTIVE

To evaluate the prognostic impact of diabetes mellitus (DM) in patients with heart failure and preserved ejection fraction (HFPEF) DESIGN: A five-year prospective observational study

SETTING

Population of 368 consecutive patients from 11 healthcare establishments

PATIENTS

All patients hospitalised for a first episode of HFPEF in 2000 in the Somme department, France.

INTERVENTIONS

Diagnosis of heart failure (HF) was validated during the index hospitalisation by two independent cardiologists. Diabetic and non-diabetic groups were compared. After discharge, patients were managed by the general practitioner or referring cardiologist.

MAIN OUTCOME MEASURES

Overall and cardiovascular mortality.

RESULTS

The 96 diabetic patients (26%) were younger and had a higher prevalence of clinical coronary artery disease (CAD) than non-diabetic patients. Patients with DM had higher discharge prescription rates of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, nitrates and statins. During the five-year follow-up, 208 patients died (43.5%). DM was a potent independent predictor of five-year overall mortality (HR 1.77, 95% CI 1.27 to 2.48, p = 0.001). Compared to the expected survival of the age-matched and gender-matched general population, the five-year survival of patients with DM was dramatically lower (32% vs 79%). The five-year relative survival (observed/expected survival) of diabetic patients was lower than that of the non-diabetic group (41% vs 68%). Cardiovascular causes were responsible for >60% of deaths in the DM group. DM was associated with an increased risk of death in patients with clinical CAD (HR 1.82, 95% CI 1.02 to 3.25, p = 0.04), as well as in patients without clinical CAD (HR 1.85, 95% CI 1.22 to 2.82, p = 0.004).

CONCLUSION

In patients with HFPEF, DM is a strong predictor of poorer long-term survival.

Authors+Show Affiliations

INSERM, ERI 12, University Hospital Amiens, Amiens, France. tribouilloy.christophe@chu-amiens.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18208832

Citation

Tribouilloy, C, et al. "Prognostic Impact of Diabetes Mellitus in Patients With Heart Failure and Preserved Ejection Fraction: a Prospective Five-year Study." Heart (British Cardiac Society), vol. 94, no. 11, 2008, pp. 1450-5.
Tribouilloy C, Rusinaru D, Mahjoub H, et al. Prognostic impact of diabetes mellitus in patients with heart failure and preserved ejection fraction: a prospective five-year study. Heart. 2008;94(11):1450-5.
Tribouilloy, C., Rusinaru, D., Mahjoub, H., Tartière, J. M., Kesri-Tartière, L., Godard, S., & Peltier, M. (2008). Prognostic impact of diabetes mellitus in patients with heart failure and preserved ejection fraction: a prospective five-year study. Heart (British Cardiac Society), 94(11), 1450-5. https://doi.org/10.1136/hrt.2007.128769
Tribouilloy C, et al. Prognostic Impact of Diabetes Mellitus in Patients With Heart Failure and Preserved Ejection Fraction: a Prospective Five-year Study. Heart. 2008;94(11):1450-5. PubMed PMID: 18208832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic impact of diabetes mellitus in patients with heart failure and preserved ejection fraction: a prospective five-year study. AU - Tribouilloy,C, AU - Rusinaru,D, AU - Mahjoub,H, AU - Tartière,J-M, AU - Kesri-Tartière,L, AU - Godard,S, AU - Peltier,M, Y1 - 2008/01/20/ PY - 2008/1/23/pubmed PY - 2008/12/17/medline PY - 2008/1/23/entrez SP - 1450 EP - 5 JF - Heart (British Cardiac Society) JO - Heart VL - 94 IS - 11 N2 - OBJECTIVE: To evaluate the prognostic impact of diabetes mellitus (DM) in patients with heart failure and preserved ejection fraction (HFPEF) DESIGN: A five-year prospective observational study SETTING: Population of 368 consecutive patients from 11 healthcare establishments PATIENTS: All patients hospitalised for a first episode of HFPEF in 2000 in the Somme department, France. INTERVENTIONS: Diagnosis of heart failure (HF) was validated during the index hospitalisation by two independent cardiologists. Diabetic and non-diabetic groups were compared. After discharge, patients were managed by the general practitioner or referring cardiologist. MAIN OUTCOME MEASURES: Overall and cardiovascular mortality. RESULTS: The 96 diabetic patients (26%) were younger and had a higher prevalence of clinical coronary artery disease (CAD) than non-diabetic patients. Patients with DM had higher discharge prescription rates of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, nitrates and statins. During the five-year follow-up, 208 patients died (43.5%). DM was a potent independent predictor of five-year overall mortality (HR 1.77, 95% CI 1.27 to 2.48, p = 0.001). Compared to the expected survival of the age-matched and gender-matched general population, the five-year survival of patients with DM was dramatically lower (32% vs 79%). The five-year relative survival (observed/expected survival) of diabetic patients was lower than that of the non-diabetic group (41% vs 68%). Cardiovascular causes were responsible for >60% of deaths in the DM group. DM was associated with an increased risk of death in patients with clinical CAD (HR 1.82, 95% CI 1.02 to 3.25, p = 0.04), as well as in patients without clinical CAD (HR 1.85, 95% CI 1.22 to 2.82, p = 0.004). CONCLUSION: In patients with HFPEF, DM is a strong predictor of poorer long-term survival. SN - 1468-201X UR - https://www.unboundmedicine.com/medline/citation/18208832/Prognostic_impact_of_diabetes_mellitus_in_patients_with_heart_failure_and_preserved_ejection_fraction:_a_prospective_five_year_study_ L2 - https://heart.bmj.com/lookup/pmidlookup?view=long&pmid=18208832 DB - PRIME DP - Unbound Medicine ER -