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. Issue 7 (5th July 2017)

• Record Type: Journal Article
• Authors: 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
• Other Names: Barlera Simona investigator.; Franzosi Maria Grazia investigator.; Maggioni Aldo P. investigator.; Porcu Maurizio investigator.; Franzosi Maria Grazia investigator.; Maggioni Aldo P. investigator.; Porcu Maurizio investigator.; Yusuf Salim investigator.; Camerini Fulvio investigator.; Cohn Jay N. investigator.; Decarli Adriano investigator.; Pitt Bertram investigator.; Sleight Peter investigator.; Poole‐Wilson Philip A. investigator.; Geraci Enrico investigator.; Scherillo Marino investigator.; Fabbri Gianna investigator.; Bartolomei Barbara investigator.; Bertoli Daniele investigator.; Cobelli Franco investigator.; Fresco Claudio investigator.; Ledda Antonietta investigator.; Levantesi Giacomo investigator.; Opasich Cristina investigator.; Rusconi Franco investigator.; Sinagra Gianfranco investigator.; Turazza Fabio investigator.; Volpi Alberto investigator.; Ceseri Martina investigator.; Alongi Gianluca investigator.; Atzori Antonio investigator.; Bambi Filippo investigator.; Bastarolo Desiree investigator.; Bianchini Francesca investigator.; Cangioli Iacopo investigator.; Canu Vittoriana investigator.; Caporusso Concetta investigator.; Cenni Gabriele investigator.; Cintelli Laura investigator.; Cocchio Michele investigator.; Confente Alessia investigator.; Fenicia Eva investigator.; Friso Giorgio investigator.; Gianfriddo Marco investigator.; Grilli Gianluca investigator.; Lazzaro Beatrice investigator.; Lonardo Giuseppe investigator.; Luise Alessia investigator.; Nota Rachele investigator.; Orlando Mariaelena investigator.; Petrolo Rosaria investigator.; Pierattini Chiara investigator.; Pierota Valeria investigator.; Provenzani Alessandro investigator.; Quartuccio Velia investigator.; Ragno Anna investigator.; Serio Chiara investigator.; Spolaor Alvise investigator.; Tafi Arianna investigator.; Tellaroli Elisa investigator.; Ghio Stefano investigator.; Ghizzardi Elisa investigator.; Masson Serge investigator.; Franzosi Maria Grazia investigator.; Crociati Lella investigator.; La Rovere Maria Teresa investigator.; Corrà Ugo investigator.; Finzi Andrea investigator.; Barlera Simona investigator.; Gorini Marco investigator.; Milani Valentina investigator.; Orsini Giampietro investigator.; Bianchini Elisa investigator.; Cabiddu Silvia investigator.; Cangioli Ilaria investigator.; Cipressa Laura investigator.; Cipressa Maria Lucia investigator.; Di Bitetto Giuseppina investigator.; Ferri Barbara investigator.; Galbiati Luisa investigator.; Lorimer Andrea investigator.; Pera Carla investigator.; Priami Paola investigator.; Vasamì Antonella investigator.; Moccetti T. investigator.; Rossi M.G. investigator.; Pasotti E. investigator.; Vaghi F. investigator.; Roncarolo P. investigator.; Zunino M.T. investigator.; Matta F. investigator.; Perinetto E. 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Gumina D. investigator.; Cavallaro A. investigator.; Piccione G. investigator.; Ferrante R. investigator.; Blandino M. investigator.; Iudicello M.S. investigator.; Mossuti E. investigator.; Romano G. investigator.; Lombardo L. investigator.; Monastra P. investigator.; Di Vincenzo D. investigator.; Porcu M. investigator.; Orrù P. investigator.; Muscas F. investigator.; Giardina G. investigator.; Corda M. investigator.; Locci G. investigator.; Podda A. investigator.; Ledda M. investigator.; Siddi P. investigator.; Lai C. investigator.; Pili G. investigator.; Mercuro G. investigator.; Mureddu G. investigator.; Ganau A. investigator.; Meloni G. investigator.; Poddighe G. investigator.; Sanna G. investigator.;
• Is Part Of: Journal of the American Heart Association. Volume 6:Issue 7(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-07-05
• Subjects: chronic heart failure -- diabetes mellitus -- glycemic control -- heart failure -- mortality -- prediabetes; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.116.005156
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre‐DM) 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 DM and pre‐DM on survival outcomes in the GISSI‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) trial. Methods and Results: 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 GISSI‐HF trial, who were stratified by presence of DM (n=2852), pre‐DM (n=2013), and non‐DM (n=2070) at baseline. Compared with non‐DM patients, those with DM 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‐DM patients and those with pre‐DM. Cox regression analysis showed that DM, but not pre‐DM, was associated with an increased risk of all‐cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28–1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13–1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all‐cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02–1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01–1.29, respectively). Conclusions: Presence of DM was independently associated with poor long‐term survival outcomes in patients with chronic heart failure. Clinical Trial Registration: URL:http://www.clinicaltrials.gov . Unique identifier: NCT00336336.