Pre-existing type 2 diabetes is associated with increased all-cause death independently of echocardiographic predictors of poor prognosis only in ischemic heart disease.
Aged
Biomarkers
/ blood
Cause of Death
Diabetes Mellitus, Type 2
/ diagnosis
Echocardiography
Female
Heart Disease Risk Factors
Heart Failure
/ diagnostic imaging
Hemodynamics
Humans
Male
Myocardial Ischemia
/ diagnostic imaging
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Troponin I
/ blood
Ventricular Function, Left
Cardiac biomarkers
Chronic heart failure
Echocardiography
Prognosis
Type 2 diabetes mellitus
Journal
Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474
Informations de publication
Date de publication:
30 10 2020
30 10 2020
Historique:
received:
30
05
2020
revised:
27
06
2020
accepted:
06
07
2020
pubmed:
10
9
2020
medline:
15
12
2020
entrez:
9
9
2020
Statut:
ppublish
Résumé
It is unknown whether the prognostic role of diabetes (T2DM) in outpatients with chronic heart failure (CHF) is independent of the most important echocardiographic markers of poor prognosis. The aims of this analysis were to evaluate whether T2DM modifies the risk of mortality in CHF patients stratified by etiology of disease or by right-ventricular to pulmonary arterial coupling at echocardiography and to evaluate how T2DM interacts with the prognostic role of cardiac plasma biomarkers. This is a retrospective analysis of 1627 CHF outpatients who underwent a complete echocardiographic examination. During a median follow-up period of 63 months 255 patients died. Poor right-ventricular to pulmonary arterial coupling and reduced left ventricular ejection fraction were independent predictors of outcome, whereas ischemic etiology and T2DM were not. T2DM interacted with etiology increasing the risk of mortality by 32% among patients with ischemic disease (p = 0.003). Elevated hsTNI plasma levels were associated with poor survival in T2DM but not in non-diabetic patients. T2DM signals a worse outcome in ischemic CHF patients regardless of the echocardiographic phenotype. High plasma levels of hsTNI are stronger predictors of mortality in CHF patients with T2DM than in patients without diabetes.
Sections du résumé
BACKGROUND AND AIMS
It is unknown whether the prognostic role of diabetes (T2DM) in outpatients with chronic heart failure (CHF) is independent of the most important echocardiographic markers of poor prognosis. The aims of this analysis were to evaluate whether T2DM modifies the risk of mortality in CHF patients stratified by etiology of disease or by right-ventricular to pulmonary arterial coupling at echocardiography and to evaluate how T2DM interacts with the prognostic role of cardiac plasma biomarkers.
METHODS AND RESULTS
This is a retrospective analysis of 1627 CHF outpatients who underwent a complete echocardiographic examination. During a median follow-up period of 63 months 255 patients died. Poor right-ventricular to pulmonary arterial coupling and reduced left ventricular ejection fraction were independent predictors of outcome, whereas ischemic etiology and T2DM were not. T2DM interacted with etiology increasing the risk of mortality by 32% among patients with ischemic disease (p = 0.003). Elevated hsTNI plasma levels were associated with poor survival in T2DM but not in non-diabetic patients.
CONCLUSION
T2DM signals a worse outcome in ischemic CHF patients regardless of the echocardiographic phenotype. High plasma levels of hsTNI are stronger predictors of mortality in CHF patients with T2DM than in patients without diabetes.
Identifiants
pubmed: 32900568
pii: S0939-4753(20)30283-0
doi: 10.1016/j.numecd.2020.07.008
pii:
doi:
Substances chimiques
Biomarkers
0
Troponin I
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2036-2040Informations de copyright
Copyright © 2020. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None declared.