AIMS: To determine whether the risk of adverse cardiovascular (CV) outcomes associated with diabetes differs in patients with low and preserved ejection fraction (EF) heart failure (HF). METHODS AND RESULTS: We analysed outcomes in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme which randomized 7599 patients with symptomatic HF and a broad range of EF. The prevalence of diabetes was 28.3% in patients with preserved EF (>40%) and 28.5% in those with low EF (<or=40%). Diabetes was associated with a greater relative risk of CV death or HF hospitalization in patients with preserved EF [hazard ratio (HR) 2.0 (1.70-2.36)] than in patients with low EF [HR 1.60 (1.44-1.77); interaction test P = 0.0009]. For all-cause mortality, the risk conferred by diabetes was similar in both low and preserved EF groups. The effect of candesartan in reducing CV morbidity and mortality outcomes was not modified by having diabetes at baseline (P = 0.09 test for interaction). CONCLUSION: Diabetes was an independent predictor of CV morbidity and mortality in patients with HF, regardless of EF. The relative risk of CV death or HF hospitalization conferred by diabetes was significantly greater in patients with preserved when compared with those with low EF HF.
RCT Entities:
AIMS: To determine whether the risk of adverse cardiovascular (CV) outcomes associated with diabetes differs in patients with low and preserved ejection fraction (EF) heart failure (HF). METHODS AND RESULTS: We analysed outcomes in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme which randomized 7599 patients with symptomatic HF and a broad range of EF. The prevalence of diabetes was 28.3% in patients with preserved EF (>40%) and 28.5% in those with low EF (<or=40%). Diabetes was associated with a greater relative risk of CV death or HF hospitalization in patients with preserved EF [hazard ratio (HR) 2.0 (1.70-2.36)] than in patients with low EF [HR 1.60 (1.44-1.77); interaction test P = 0.0009]. For all-cause mortality, the risk conferred by diabetes was similar in both low and preserved EF groups. The effect of candesartan in reducing CV morbidity and mortality outcomes was not modified by having diabetes at baseline (P = 0.09 test for interaction). CONCLUSION:Diabetes was an independent predictor of CV morbidity and mortality in patients with HF, regardless of EF. The relative risk of CV death or HF hospitalization conferred by diabetes was significantly greater in patients with preserved when compared with those with low EF HF.
Authors: Oliver Riedel; C Ohlmeier; D Enders; A Elsässer; D Vizcaya; A Michel; S Eberhard; N Schlothauer; J Berg; E Garbe Journal: Clin Res Cardiol Date: 2018-02-05 Impact factor: 5.460
Authors: Robert J Mentz; Jacob P Kelly; Thomas G von Lueder; Adriaan A Voors; Carolyn S P Lam; Martin R Cowie; Keld Kjeldsen; Ewa A Jankowska; Dan Atar; Javed Butler; Mona Fiuzat; Faiez Zannad; Bertram Pitt; Christopher M O'Connor Journal: J Am Coll Cardiol Date: 2014-11-24 Impact factor: 24.094
Authors: Selma F Mohammed; Barry A Borlaug; Véronique L Roger; Sultan A Mirzoyev; Richard J Rodeheffer; Julio A Chirinos; Margaret M Redfield Journal: Circ Heart Fail Date: 2012-10-17 Impact factor: 8.790
Authors: David Preiss; Sofia Zetterstrand; John J V McMurray; Jan Ostergren; Eric L Michelson; Christopher B Granger; Salim Yusuf; Karl Swedberg; Marc A Pfeffer; Hertzel C Gerstein; Naveed Sattar Journal: Diabetes Care Date: 2009-02-05 Impact factor: 19.112