BACKGROUND: Heart failure (HF) occurs more frequently and is a significant cause of mortality in diabetic patients. The purpose of the current study is to ascertain risk factors that are predictive of HF hospitalizations in type 2 diabetic patients. METHODS: Longitudinal observational study of type 2 diabetic patients with baseline diastolic blood pressures > or =80 mm Hg and no history of New York Heart Association class III-IV HF or a serum creatinine > or =2.5 mg/dL nested within a randomized clinical trial. The outcome measure of this study was the first occurrence of HF hospitalization over a 5-year follow-up period. RESULTS: Patients with overt albuminuria at baseline had a higher and earlier occurrence of HF hospitalizations than those with micro- or normoalbuminuria (13.6% versus 3.3%, odds ratio [OR]=3.1, 95% confidence interval [CI]=2.15-4.60, P<.0001). In the multiple logistic regression analyses, the presence of overt albuminuria (OR 5.4, 95% CI=2.3-12.5, P<.001), history of myocardial infarction (OR 4.6, 95% CI=1.6-13.1, P=.004) and a history of New York Heart Association Class I or II HF (OR 8.0, 95% CI=2.2-28.6, P=.0014) at baseline were independently associated with HF hospitalizations. CONCLUSIONS: Overt albuminuria predicts the occurrence of HF hospitalizations in type 2 diabetic patients. Thus early aggressive treatment of diabetic nephropathy should be investigated as a means of preventing of HF.
BACKGROUND:Heart failure (HF) occurs more frequently and is a significant cause of mortality in diabeticpatients. The purpose of the current study is to ascertain risk factors that are predictive of HF hospitalizations in type 2 diabeticpatients. METHODS: Longitudinal observational study of type 2 diabeticpatients with baseline diastolic blood pressures > or =80 mm Hg and no history of New York Heart Association class III-IV HF or a serum creatinine > or =2.5 mg/dL nested within a randomized clinical trial. The outcome measure of this study was the first occurrence of HF hospitalization over a 5-year follow-up period. RESULTS:Patients with overt albuminuria at baseline had a higher and earlier occurrence of HF hospitalizations than those with micro- or normoalbuminuria (13.6% versus 3.3%, odds ratio [OR]=3.1, 95% confidence interval [CI]=2.15-4.60, P<.0001). In the multiple logistic regression analyses, the presence of overt albuminuria (OR 5.4, 95% CI=2.3-12.5, P<.001), history of myocardial infarction (OR 4.6, 95% CI=1.6-13.1, P=.004) and a history of New York Heart Association Class I or II HF (OR 8.0, 95% CI=2.2-28.6, P=.0014) at baseline were independently associated with HF hospitalizations. CONCLUSIONS: Overt albuminuria predicts the occurrence of HF hospitalizations in type 2 diabeticpatients. Thus early aggressive treatment of diabetic nephropathy should be investigated as a means of preventing of HF.
Authors: Benjamin M Scirica; Ofri Mosenzon; Deepak L Bhatt; Jacob A Udell; Ph Gabriel Steg; Darren K McGuire; KyungAh Im; Estella Kanevsky; Christina Stahre; Mikaela Sjöstrand; Itamar Raz; Eugene Braunwald Journal: JAMA Cardiol Date: 2018-02-01 Impact factor: 14.676
Authors: Xilin Yang; Ronald C Ma; Wing-Yee So; Alice P Kong; Gary T Ko; Chun-Shun Ho; Christopher W Lam; Clive S Cockram; Peter C Tong; Juliana C Chan Journal: Cardiovasc Diabetol Date: 2008-04-22 Impact factor: 9.951