Risk Related to Pre-Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction Insights From Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial /

BACKGROUND: The prevalence of pre-diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-...

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Bibliográfiai részletek
Szerzők: Kristensen Søren L.
Preiss David
Jhund Pardeep S.
Squire Iain
Cardoso José Silva
Merkely Béla Péter
Kollaborációs szervezet: ARADIGM-HF Investigators and Committees
Merkely Béla
Andrássy G.
Bakai J.
Csapó K.
Cziraki A.
Édes I.
Forster Tamás
Hajkó E.
Illés A.
Jánoskúti L.
Kovács Z.
László Zoltán
Lupkovics G.
Matoltsy A.
Müller G.
Nagy A.
Noori E.
Nyolczas Noémi
Papp A.
Salamon C.
Szántai G.
Szőcs A.
Tomcsányi J.
Tóth D.
Varjú I.
Vertes A.
Zámolyi K.
Zilahi Z.
Dokumentumtípus: Cikk
Megjelent: 2016
Sorozat:CIRCULATION-HEART FAILURE 9 No. 1
Tárgyszavak:
doi:10.1161/CIRCHEARTFAILURE.115.002560

mtmt:3002771
Online Access:http://publicatio.bibl.u-szeged.hu/24152
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024 7 |a 10.1161/CIRCHEARTFAILURE.115.002560  |2 doi 
024 7 |a 3002771  |2 mtmt 
040 |a SZTE Publicatio Repozitórium  |b hun 
041 |a Angol 
100 1 |a Kristensen Søren L. 
245 1 0 |a Risk Related to Pre-Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction  |h [elektronikus dokumentum] :  |b Insights From Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial /  |c  Kristensen Søren L. 
260 |c 2016 
300 |a Terjedelem: 12-Azonosító: e002560 
490 0 |a CIRCULATION-HEART FAILURE  |v 9 No. 1 
520 3 |a BACKGROUND: The prevalence of pre-diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial. METHODS AND RESULTS: We examined clinical outcomes in 8399 patients with heart failure and reduced ejection fraction according to history of diabetes mellitus and glycemic status (baseline hemoglobin A1c [HbA1c]: <6.0% [<42 mmol/mol], 6.0%-6.4% [42-47 mmol/mol; pre-diabetes mellitus], and >/=6.5% [>/=48 mmol/mol; diabetes mellitus]), in Cox regression models adjusted for known predictors of poor outcome. Patients with a history of diabetes mellitus (n=2907 [35%]) had a higher risk of the primary composite outcome of heart failure hospitalization or cardiovascular mortality compared with those without a history of diabetes mellitus: adjusted hazard ratio, 1.38; 95% confidence interval, 1.25 to 1.52; P<0.001. HbA1c measurement showed that an additional 1106 (13% of total) patients had undiagnosed diabetes mellitus and 2103 (25%) had pre-diabetes mellitus. The hazard ratio for patients with undiagnosed diabetes mellitus (HbA1c, >6.5%) and known diabetes mellitus compared with those with HbA1c<6.0% was 1.39 (1.17-1.64); P<0.001 and 1.64 (1.43-1.87); P<0.001, respectively. Patients with pre-diabetes mellitus were also at higher risk (hazard ratio, 1.27 [1.10-1.47]; P<0.001) compared with those with HbA1c<6.0%. The benefit of LCZ696 (sacubitril/valsartan) compared with enalapril was consistent across the range of HbA1c in the trial. CONCLUSIONS: In patients with heart failure and reduced ejection fraction, dysglycemia is common and pre-diabetes mellitus is associated with a higher risk of adverse cardiovascular outcomes (compared with patients with no diabetes mellitus and HbA1c <6.0%). LCZ696 was beneficial compared with enalapril, irrespective of glycemic status. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255. 
650 4 |a Klinikai orvostan 
700 0 1 |a Preiss David  |e aut 
700 0 1 |a Jhund Pardeep S.  |e aut 
700 0 1 |a Squire Iain  |e aut 
700 0 1 |a Cardoso José Silva  |e aut 
700 0 1 |a Merkely Béla Péter  |e aut 
700 0 2 |a Kollaborációs szervezet: ARADIGM-HF Investigators and Committees  |e aut 
700 0 2 |a Merkely Béla  |e aut 
700 0 2 |a Andrássy G.  |e aut 
700 0 2 |a Bakai J.  |e aut 
700 0 2 |a Csapó K.  |e aut 
700 0 2 |a Cziraki A.  |e aut 
700 0 2 |a Édes I.  |e aut 
700 0 2 |a Forster Tamás  |e aut 
700 0 2 |a Hajkó E.  |e aut 
700 0 2 |a Illés A.  |e aut 
700 0 2 |a Jánoskúti L.  |e aut 
700 0 2 |a Kovács Z.  |e aut 
700 0 2 |a László Zoltán  |e aut 
700 0 2 |a Lupkovics G.  |e aut 
700 0 2 |a Matoltsy A.  |e aut 
700 0 2 |a Müller G.  |e aut 
700 0 2 |a Nagy A.  |e aut 
700 0 2 |a Noori E.  |e aut 
700 0 2 |a Nyolczas Noémi  |e aut 
700 0 2 |a Papp A.  |e aut 
700 0 2 |a Salamon C.  |e aut 
700 0 2 |a Szántai G.  |e aut 
700 0 2 |a Szőcs A.  |e aut 
700 0 2 |a Tomcsányi J.  |e aut 
700 0 2 |a Tóth D.  |e aut 
700 0 2 |a Varjú I.  |e aut 
700 0 2 |a Vertes A.  |e aut 
700 0 2 |a Zámolyi K.  |e aut 
700 0 2 |a Zilahi Z.  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/24152/1/Kristensen.pdf  |z Dokumentum-elérés