Diabetes mellitus is associated with adverse prognosis in chronic heart failure of ischaemic and non-ischaemic aetiology
Diabetes mellitus is associated with adverse prognosis in chronic heart failure of ischaemic and non-ischaemic aetiology
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DOI：
10.1177/1479164112471064
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发表时间：
2013-07-01
影响因子：
2.4
通讯作者：
Kearney, Mark T.
中科院分区：
文献类型：
--
作者：
Cubbon, Richard M.;Adams, Brook;Kearney, Mark T.
背景资料：目前还不清楚糖尿病（DM）是否是一个不良预后因素，慢性心力衰竭（CHF）的缺血性和非缺血性病因管理与当代循证care.Methods：在总数，1091例门诊CHF与射血分数降低进行了前瞻性观察，平均为960天。总死亡率和心血管死亡率进行量化后，占潜在的confersider.Results：在总的，25.7%的患者有DM，这组更有可能有CHF的缺血性病因，更有症状。除了更大剂量的袢利尿剂外，DM患者接受了类似的基于药物和器械的治疗。糖尿病与总死亡率和心血管死亡率的粗风险和调整后的风险大约加倍相关。糖尿病与缺血性和非缺血性心肌病患者的这些结果的关联是相似的magnitude.Conclusions：尽管CHF的管理进展，DM仍然是一个主要的不良预后特征，无论缺血/非缺血性病因。
Background: It is unclear whether diabetes mellitus (DM) is an adverse prognostic factor in chronic heart failure (CHF) of ischaemic and non-ischaemic aetiology managed with contemporary evidence-based care.Methods: In total, 1091 outpatients with CHF with reduced ejection fraction were prospectively observed for a mean of 960 days. Total and cardiovascular mortality was quantified after accounting for potential confounders.Results: In total, 25.7% of patients had DM; this group was more likely to have CHF of ischaemic aetiology and was more symptomatic. Patients with DM received comparable medical- and device-based therapies, except for greater doses of loop diuretic. DM was associated with approximately doubled crude and adjusted risk of total and cardiovascular mortality. The association of diabetes with these outcomes in patients with ischaemic and non-ischaemic cardiomyopathies was of similar magnitude.Conclusions: In spite of advances in the management of CHF, DM remains a major adverse prognostic feature, irrespective of ischaemic/non-ischaemic aetiology.