Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure

Results from the ESC-HFA Heart Failure Long-Term Registry

Marco Dauriz, Giovanni Targher, Cécile Laroche, Pier Luigi Temporelli, Roberto Ferrari, Stephan Anker, Andrew Coats, Gerasimos Filippatos, Maria Crespo-Leiro, Alexandre Mebazaa, Massimo F Piepoli, Aldo Pietro Maggioni, Luigi Tavazzi

    Research output: Contribution to journalArticleResearchpeer-review

    24 Citations (Scopus)

    Abstract

    OBJECTIVE: Diabetes mellitus is associated with an increased risk of cardiovascular disease (CVD) and death. Because the prevalence of diabetes is rising worldwide and chronic heart failure (CHF) is becoming increasingly common with the aging population, it is timely to examine the impact of diabetes per se on 1-year adverse outcomes in patients with CHF. RESEARCH DESIGN AND METHODS: We prospectively assessed whether diabetes status independently affected the 1-year risk of all-cause and CVD mortality and first hospitalization for worsening heart failure (HF) in a multinational cohort of 9,428 outpatients with CHF enrolled in the European Society of Cardiology and Heart Failure Association Long-Term Registry. RESULTS: Compared with those patientswithout diabetes, patientswith diabetes (n = 3,440, 36.5%) had higher cumulative rates of 1-year all-cause death (9.4% vs. 7.2%; adjusted hazard ratio [HR] 1.28; 95% CI 1.07-1.54), CVD death (4.8% vs. 3.8%; adjusted HR 1.28; 95% CI 0.99-1.66), and HF hospitalization (13.8% vs. 9.3%; adjusted HR 1.37; 95% CI 1.17-1.60), all independent of age, sex, BMI, smoking, systolic blood pressure, estimated glomerular filtration rate, hemoglobin, HF etiology, left ventricular ejection fraction, hypertension, statin use, and prior stroke or chronic obstructive pulmonary disease. Among CHF patients with HbA1c measurements available at baseline (n = 2,567), there was a significant and independent association between increasing HbA1c levels and the risk of 1-year survival outcomes. CONCLUSIONS: The presence of diabetes markedly increases the risk of 1-year adverse clinical outcomes in outpatients with CHF independent of multiple common risk factors. More effective and personalized treatment for diabetes should be considered in this particularly high-risk patient population.

    Original languageEnglish
    Pages (from-to)671-678
    Number of pages8
    JournalDiabetes Care
    Volume40
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2017

    Cite this

    Dauriz, Marco ; Targher, Giovanni ; Laroche, Cécile ; Temporelli, Pier Luigi ; Ferrari, Roberto ; Anker, Stephan ; Coats, Andrew ; Filippatos, Gerasimos ; Crespo-Leiro, Maria ; Mebazaa, Alexandre ; Piepoli, Massimo F ; Maggioni, Aldo Pietro ; Tavazzi, Luigi. / Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure : Results from the ESC-HFA Heart Failure Long-Term Registry. In: Diabetes Care. 2017 ; Vol. 40, No. 5. pp. 671-678.
    @article{60e69ed00f7a4edcb63300c16f2c24d9,
    title = "Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure: Results from the ESC-HFA Heart Failure Long-Term Registry",
    abstract = "OBJECTIVE: Diabetes mellitus is associated with an increased risk of cardiovascular disease (CVD) and death. Because the prevalence of diabetes is rising worldwide and chronic heart failure (CHF) is becoming increasingly common with the aging population, it is timely to examine the impact of diabetes per se on 1-year adverse outcomes in patients with CHF. RESEARCH DESIGN AND METHODS: We prospectively assessed whether diabetes status independently affected the 1-year risk of all-cause and CVD mortality and first hospitalization for worsening heart failure (HF) in a multinational cohort of 9,428 outpatients with CHF enrolled in the European Society of Cardiology and Heart Failure Association Long-Term Registry. RESULTS: Compared with those patientswithout diabetes, patientswith diabetes (n = 3,440, 36.5{\%}) had higher cumulative rates of 1-year all-cause death (9.4{\%} vs. 7.2{\%}; adjusted hazard ratio [HR] 1.28; 95{\%} CI 1.07-1.54), CVD death (4.8{\%} vs. 3.8{\%}; adjusted HR 1.28; 95{\%} CI 0.99-1.66), and HF hospitalization (13.8{\%} vs. 9.3{\%}; adjusted HR 1.37; 95{\%} CI 1.17-1.60), all independent of age, sex, BMI, smoking, systolic blood pressure, estimated glomerular filtration rate, hemoglobin, HF etiology, left ventricular ejection fraction, hypertension, statin use, and prior stroke or chronic obstructive pulmonary disease. Among CHF patients with HbA1c measurements available at baseline (n = 2,567), there was a significant and independent association between increasing HbA1c levels and the risk of 1-year survival outcomes. CONCLUSIONS: The presence of diabetes markedly increases the risk of 1-year adverse clinical outcomes in outpatients with CHF independent of multiple common risk factors. More effective and personalized treatment for diabetes should be considered in this particularly high-risk patient population.",
    author = "Marco Dauriz and Giovanni Targher and C{\'e}cile Laroche and Temporelli, {Pier Luigi} and Roberto Ferrari and Stephan Anker and Andrew Coats and Gerasimos Filippatos and Maria Crespo-Leiro and Alexandre Mebazaa and Piepoli, {Massimo F} and Maggioni, {Aldo Pietro} and Luigi Tavazzi",
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    Dauriz, M, Targher, G, Laroche, C, Temporelli, PL, Ferrari, R, Anker, S, Coats, A, Filippatos, G, Crespo-Leiro, M, Mebazaa, A, Piepoli, MF, Maggioni, AP & Tavazzi, L 2017, 'Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure: Results from the ESC-HFA Heart Failure Long-Term Registry', Diabetes Care, vol. 40, no. 5, pp. 671-678. https://doi.org/10.2337/dc16-2016

    Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure : Results from the ESC-HFA Heart Failure Long-Term Registry. / Dauriz, Marco; Targher, Giovanni; Laroche, Cécile; Temporelli, Pier Luigi; Ferrari, Roberto; Anker, Stephan; Coats, Andrew; Filippatos, Gerasimos; Crespo-Leiro, Maria; Mebazaa, Alexandre; Piepoli, Massimo F; Maggioni, Aldo Pietro; Tavazzi, Luigi.

    In: Diabetes Care, Vol. 40, No. 5, 01.05.2017, p. 671-678.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Association between diabetes and 1-year adverse clinical outcomes in a multinational cohort of ambulatory patients with chronic heart failure

    T2 - Results from the ESC-HFA Heart Failure Long-Term Registry

    AU - Dauriz, Marco

    AU - Targher, Giovanni

    AU - Laroche, Cécile

    AU - Temporelli, Pier Luigi

    AU - Ferrari, Roberto

    AU - Anker, Stephan

    AU - Coats, Andrew

    AU - Filippatos, Gerasimos

    AU - Crespo-Leiro, Maria

    AU - Mebazaa, Alexandre

    AU - Piepoli, Massimo F

    AU - Maggioni, Aldo Pietro

    AU - Tavazzi, Luigi

    PY - 2017/5/1

    Y1 - 2017/5/1

    N2 - OBJECTIVE: Diabetes mellitus is associated with an increased risk of cardiovascular disease (CVD) and death. Because the prevalence of diabetes is rising worldwide and chronic heart failure (CHF) is becoming increasingly common with the aging population, it is timely to examine the impact of diabetes per se on 1-year adverse outcomes in patients with CHF. RESEARCH DESIGN AND METHODS: We prospectively assessed whether diabetes status independently affected the 1-year risk of all-cause and CVD mortality and first hospitalization for worsening heart failure (HF) in a multinational cohort of 9,428 outpatients with CHF enrolled in the European Society of Cardiology and Heart Failure Association Long-Term Registry. RESULTS: Compared with those patientswithout diabetes, patientswith diabetes (n = 3,440, 36.5%) had higher cumulative rates of 1-year all-cause death (9.4% vs. 7.2%; adjusted hazard ratio [HR] 1.28; 95% CI 1.07-1.54), CVD death (4.8% vs. 3.8%; adjusted HR 1.28; 95% CI 0.99-1.66), and HF hospitalization (13.8% vs. 9.3%; adjusted HR 1.37; 95% CI 1.17-1.60), all independent of age, sex, BMI, smoking, systolic blood pressure, estimated glomerular filtration rate, hemoglobin, HF etiology, left ventricular ejection fraction, hypertension, statin use, and prior stroke or chronic obstructive pulmonary disease. Among CHF patients with HbA1c measurements available at baseline (n = 2,567), there was a significant and independent association between increasing HbA1c levels and the risk of 1-year survival outcomes. CONCLUSIONS: The presence of diabetes markedly increases the risk of 1-year adverse clinical outcomes in outpatients with CHF independent of multiple common risk factors. More effective and personalized treatment for diabetes should be considered in this particularly high-risk patient population.

    AB - OBJECTIVE: Diabetes mellitus is associated with an increased risk of cardiovascular disease (CVD) and death. Because the prevalence of diabetes is rising worldwide and chronic heart failure (CHF) is becoming increasingly common with the aging population, it is timely to examine the impact of diabetes per se on 1-year adverse outcomes in patients with CHF. RESEARCH DESIGN AND METHODS: We prospectively assessed whether diabetes status independently affected the 1-year risk of all-cause and CVD mortality and first hospitalization for worsening heart failure (HF) in a multinational cohort of 9,428 outpatients with CHF enrolled in the European Society of Cardiology and Heart Failure Association Long-Term Registry. RESULTS: Compared with those patientswithout diabetes, patientswith diabetes (n = 3,440, 36.5%) had higher cumulative rates of 1-year all-cause death (9.4% vs. 7.2%; adjusted hazard ratio [HR] 1.28; 95% CI 1.07-1.54), CVD death (4.8% vs. 3.8%; adjusted HR 1.28; 95% CI 0.99-1.66), and HF hospitalization (13.8% vs. 9.3%; adjusted HR 1.37; 95% CI 1.17-1.60), all independent of age, sex, BMI, smoking, systolic blood pressure, estimated glomerular filtration rate, hemoglobin, HF etiology, left ventricular ejection fraction, hypertension, statin use, and prior stroke or chronic obstructive pulmonary disease. Among CHF patients with HbA1c measurements available at baseline (n = 2,567), there was a significant and independent association between increasing HbA1c levels and the risk of 1-year survival outcomes. CONCLUSIONS: The presence of diabetes markedly increases the risk of 1-year adverse clinical outcomes in outpatients with CHF independent of multiple common risk factors. More effective and personalized treatment for diabetes should be considered in this particularly high-risk patient population.

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    U2 - 10.2337/dc16-2016

    DO - 10.2337/dc16-2016

    M3 - Article

    VL - 40

    SP - 671

    EP - 678

    JO - Diabetes Care

    JF - Diabetes Care

    SN - 0149-5992

    IS - 5

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