An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure - art. no. e1-91.e6
An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure - art. no. e1-91.e6
复制标题
DOI：
10.1016/j.ahj.2005.10.008
复制
发表时间：
2006-01-01
影响因子：
4.8
通讯作者：
Fonarow, GC
中科院分区：
文献类型：
--
作者：
Eshaghian, S;Horwich, TB;Fonarow, GC
背景在糖尿病患者中，以血红蛋白A1（c）（HbA（1c））为指标的血糖控制不良与心血管事件和新发心力衰竭（HF）的风险增加相关。然而，在糖尿病合并心力衰竭患者中，血糖控制与生存率之间的关系尚未研究。我们的研究旨在评估HbA（1c）水平与糖尿病和晚期收缩期HF.Methods患者死亡率之间的关系，我们研究了一个队列的123例糖尿病和晚期收缩期HF患者提到一个单一的中心，HbA（1c）值测量在介绍。结果本组患者70%为男性，射血分数25% ± 7，缺血性病因59%，HbA 1c 7.9 ± 1.8，糖尿病病程8.6 ± 9.0年。HbA（1c）组在年龄、性别、纽约心脏协会分级、体重指数、糖尿病病程以及胰岛素、二甲双胍和格列酮使用方面相似。HbA（1c）>7.0与射血分数升高、β受体阻滞剂和磺脲类药物使用增加相关。HbA（1c）7.0的患者（35% vs 20%，风险比2.6，95% CI 1.3-5.2，P
Background In diabetes, poor glycemic control, as indexed by hemoglobin A1(c) (HbA(1c)), is associated with increased risk of cardiovascular events and new-onset heart failure (HF). However, in patients with diabetes and HF, the relationship between glucose control and survival has not been investigated. Our study aimed to evaluate the relationship between HbA(1c) levels and mortality in patients with diabetes and advanced systolic HF.Methods We studied a cohort of 123 patients with diabetes and advanced systolic HF referred to a single center with HbA(1c) values measured at presentation. The patients were grouped based on HbA(1c): HbA(1c)7.0 (n=74).Results The cohort was 70% men, ejection fraction of 25%+/- 7, 59% ischemic etiology, HbA(1c) 7.9 +/- 1.8, and diabetes duration of 8.6 +/- 9.0 years. The HbA(1c) groups were similar in age; sex; New York Heart Association class; body mass index; diabetes duration; and insulin, metformin, and glitozone use. HbA(1c) >7.0 was associated with higher ejection fraction, increased beta-blocker, and sulfonlyurea use. Patients with HbA(1c)7.0 (35% vs 20%, hazard ratio 2.6, 95% CI 1.3-5.2, P