Marco Dauriz1, Alessandro Mantovani1, Stefano Bonapace2, Giuseppe Verlato3, Giacomo Zoppini1, Enzo Bonora1, Giovanni Targher4. 1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. 2. Division of Cardiology, ''Sacro Cuore'' Hospital, Negrar, Verona, Italy. 3. Unit of Epidemiology and Medical Statistics, Department of Medicine and Public Health, University of Verona, Verona, Italy. 4. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy giovanni.targher@univr.it.
Abstract
OBJECTIVE: Several studies have explored the impact of diabetes on mortality in patients with heart failure (HF). However, the extent to which diabetes may confer risk of mortality and hospitalization in this patient population remains imperfectly known. Here we examine the independent prognostic impact of diabetes on the long-term risk of mortality and hospitalization in patients with HF. RESEARCH DESIGN AND METHODS: PubMed, Scopus, and Web of Science from January 1990 to October 2016 were the data sources used. We included large (n ≥1,000) observational registries and randomized controlled trials with a follow-up duration of at least 1 year. Eligible studies were selected according to predefined keywords and clinical outcomes. Data from selected studies were extracted, and meta-analysis was performed using random-effects modeling. RESULTS: A total of 31 registries and 12 clinical trials with 381,725 patients with acute and chronic HF and 102,036 all-cause deaths over a median follow-up of 3 years were included in the final analysis. Diabetes was associated with a higher risk of all-cause death (random-effects hazard ratio [HR] 1.28 [95% CI 1.21, 1.35]), cardiovascular death (1.34 [1.20, 1.49]), hospitalization (1.35 [1.20, 1.50]), and the combined end point of all-cause death or hospitalization (1.41 [1.29, 1.53]). The impact of diabetes on mortality and hospitalization was greater in patients with chronic HF than in those with acute HF. Limitations included high heterogeneity and varying degrees of confounder adjustment across individual studies. CONCLUSIONS: This updated meta-analysis shows that the presence of diabetes per se adversely affects long-term survival and risk of hospitalization in patients with acute and chronic HF.
OBJECTIVE: Several studies have explored the impact of diabetes on mortality in patients with heart failure (HF). However, the extent to which diabetes may confer risk of mortality and hospitalization in this patient population remains imperfectly known. Here we examine the independent prognostic impact of diabetes on the long-term risk of mortality and hospitalization in patients with HF. RESEARCH DESIGN AND METHODS: PubMed, Scopus, and Web of Science from January 1990 to October 2016 were the data sources used. We included large (n ≥1,000) observational registries and randomized controlled trials with a follow-up duration of at least 1 year. Eligible studies were selected according to predefined keywords and clinical outcomes. Data from selected studies were extracted, and meta-analysis was performed using random-effects modeling. RESULTS: A total of 31 registries and 12 clinical trials with 381,725 patients with acute and chronic HF and 102,036 all-cause deaths over a median follow-up of 3 years were included in the final analysis. Diabetes was associated with a higher risk of all-cause death (random-effects hazard ratio [HR] 1.28 [95% CI 1.21, 1.35]), cardiovascular death (1.34 [1.20, 1.49]), hospitalization (1.35 [1.20, 1.50]), and the combined end point of all-cause death or hospitalization (1.41 [1.29, 1.53]). The impact of diabetes on mortality and hospitalization was greater in patients with chronic HF than in those with acute HF. Limitations included high heterogeneity and varying degrees of confounder adjustment across individual studies. CONCLUSIONS: This updated meta-analysis shows that the presence of diabetes per se adversely affects long-term survival and risk of hospitalization in patients with acute and chronic HF.
Authors: Anna Chu; Lu Han; Idan Roifman; Douglas S Lee; Michael E Green; Kristen Jacklin; Jennifer Walker; Roseanne Sutherland; Shahriar Khan; Eliot Frymire; Jack V Tu; Baiju R Shah Journal: CMAJ Date: 2019-11-25 Impact factor: 8.262
Authors: Eduardo Thadeu de Oliveira Correia; Jeffrey I Mechanick; Letícia Mara Dos Santos Barbetta; Antonio José Lagoeiro Jorge; Evandro Tinoco Mesquita Journal: Heart Fail Rev Date: 2022-04-04 Impact factor: 4.214
Authors: Marat Fudim; Jennifer White; Neha J Pagidipati; Yuliya Lokhnygina; Julio Wainstein; Jan Murin; Nayyar Iqbal; Peter Öhman; Renato D Lopes; Barry Reicher; Rury R Holman; Adrian F Hernandez; Robert J Mentz Journal: Circulation Date: 2019-09-23 Impact factor: 29.690
Authors: Yi Tan; Zhiguo Zhang; Chao Zheng; Kupper A Wintergerst; Bradley B Keller; Lu Cai Journal: Nat Rev Cardiol Date: 2020-02-20 Impact factor: 32.419
Authors: Guntram Schernthaner; Chaim Lotan; Elina Baltadzhieva-Trendafilova; Jonas Ceponis; Martin Clodi; Kristine Ducena; Eva Goncalvesova; Cristian Guja; Marek Honka; Andrej Janež; Nebojša Lalić; Roger Lehmann; Noémi Nyolczas; Priit Pauklin; Andrzej Rynkiewicz; Igor Sergienko; Lea Smirčić Duvnjak Journal: Cardiovasc Diabetol Date: 2018-11-21 Impact factor: 9.951