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Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro; Barlera, Simona; Franzosi, Maria Grazia; Maggioni, Aldo P.; Porcu, Maurizio; Franzosi, Maria Grazia; Maggioni, Aldo P.; Porcu, Maurizio; Yusuf, Salim; Camerini, Fulvio; Cohn, Jay N.; Decarli, Adriano; Pitt, Bertram; [...]

Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post‐Hoc Analysis of the GISSI‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) Trial

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  • Media type: E-Article
  • Title: Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post‐Hoc Analysis of the GISSI‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) Trial
  • Contributor: Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro; Barlera, Simona; Franzosi, Maria Grazia; Maggioni, Aldo P.; Porcu, Maurizio; Franzosi, Maria Grazia; Maggioni, Aldo P.; Porcu, Maurizio; Yusuf, Salim; Camerini, Fulvio; Cohn, Jay N.; Decarli, Adriano; Pitt, Bertram; [...]
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2017
  • Published in: Journal of the American Heart Association
  • Language: English
  • DOI: 10.1161/jaha.116.005156
  • ISSN: 2047-9980
  • Keywords: Cardiology and Cardiovascular Medicine
  • Origination:
  • Footnote:
  • Description: <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> The independent prognostic impact of diabetes mellitus ( <jats:styled-content style="fixed-case">DM</jats:styled-content> ) and prediabetes mellitus (pre‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> ) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of <jats:styled-content style="fixed-case">DM</jats:styled-content> and pre‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> on survival outcomes in the <jats:styled-content style="fixed-case">GISSI</jats:styled-content> ‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) trial. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> We assessed the risk of all‐cause death and the composite of all‐cause death or cardiovascular hospitalization over a median follow‐up period of 3.9 years among the 6935 chronic heart failure participants of the <jats:styled-content style="fixed-case">GISSI</jats:styled-content> ‐ <jats:styled-content style="fixed-case">HF</jats:styled-content> trial, who were stratified by presence of <jats:styled-content style="fixed-case">DM</jats:styled-content> (n=2852), pre‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> (n=2013), and non‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> (n=2070) at baseline. Compared with non‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> patients, those with <jats:styled-content style="fixed-case">DM</jats:styled-content> had remarkably higher incidence rates of all‐cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> patients and those with pre‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> . Cox regression analysis showed that <jats:styled-content style="fixed-case">DM</jats:styled-content> , but not pre‐ <jats:styled-content style="fixed-case">DM</jats:styled-content> , was associated with an increased risk of all‐cause death (adjusted hazard ratio, 1.43; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 1.28–1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 1.13–1.32), independently of established risk factors. In the <jats:styled-content style="fixed-case">DM</jats:styled-content> subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all‐cause death: adjusted hazard ratio, 1.21; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 1.02–1.43; and composite end point: adjusted hazard ratio, 1.14; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 1.01–1.29, respectively). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> Presence of <jats:styled-content style="fixed-case">DM</jats:styled-content> was independently associated with poor long‐term survival outcomes in patients with chronic heart failure. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 00336336. </jats:p> </jats:sec>
  • Access State: Open Access