© 2006 European Society of Cardiology
Decreased survival in diabetic patients with heart failure due to systolic dysfunction
Krannert Institute of Cardiology and VA Medical Center, Indiana University School of Medicine Indianapolis, IN 46202, United States
* Corresponding author. 1481 W 10th St. VAMC, Indianapolis, IN 46202, United States. Tel.: +1 317 554 0000X2081; fax: +1 317 554 0230. E-mail address: masoor.kamalesh{at}med.va.gov
 |
Abstract |
|---|
Background: Prognosis of patients with heart failure (HF) has improved in recent years due to advances in therapy. Whether this is also true for diabetic subjects with HF in clinical practice has not been studied in a prospective manner.
Methods: All patients with HF and left ventricular systolic dysfunction attending the outpatient clinic at our Veteran's Hospital between October 1999 and November 2000 were enrolled in our study and followed prospectively. Electronic medical records were accessed for data on comorbid conditions, medications, echocardiogram results and mortality information. Mean follow-up was 2.7 years.
Results: Of 495 patients with HF due to systolic dysfunction enrolled in the study, 293 (59%) had diabetes. Prevalence of hypertension, diuretic use and angiotensin converting enzyme inhibitor use was higher among diabetics. Beta-blocker usage was equal and high in both groups (60%). On follow-up, 109/273 (37%) patients in the diabetic group died, compared with 49/202 (24%) in the non-diabetic group. Independent predictors of death were diabetes (p<0.005, OR=1.73), age at enrollment (p<0.0001, OR=1.06), serum creatinine (p<0.01, OR=1.44) and diuretic use (p=0.038, OR=1.85). Beta-blocker use was associated with a decreased risk of death on univariate analysis only.
Conclusions: Our results show that diabetic patients with HF continue to have higher mortality than non-diabetic patients with HF despite advances in therapy.
Key Words: Diabetes • Heart failure • Prognosis
Received January 6, 2005; Revised July 12, 2005; Accepted October 5, 2005
Presented at the 8th annual scientific meeting of the Heart Failure Society of America in Toronto, Canada, Sept. 12–15, 2004.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  N. M. Hawkins, M. C. Petrie, P. S. Jhund, G. W. Chalmers, F. G. Dunn, and J. J.V. McMurray Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology Eur J Heart Fail, February 1, 2009; 11(2): 130 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. MacDonald, M. C. Petrie, N. M. Hawkins, J. R. Petrie, M. Fisher, R. McKelvie, D. Aguilar, H. Krum, and J. J.V. McMurray Diabetes, left ventricular systolic dysfunction, and chronic heart failure Eur. Heart J., May 2, 2008; 29(10): 1224 - 1240. [Abstract] [Full Text] [PDF]
|
|