Author + information
- Helen Parry,
- Louise Donnelly,
- Natalie van Zuydam,
- Andrew Morris,
- Douglas H. Elder,
- Alex SF Doney,
- Colin NA Palmer and
- Chim C. Lang
In diabetes, hyperglycemia increases the risk of cardiovascular events. However, intensive glycemic control predicted worse outcome in recent studies. We assessed the link between glycemic control and chronic heart failure (CHF) development.
We studied the diabetic population of Go-DARTS (n=8 890) using dispensed prescribing data, morbidity records and echocardiography data. CHF was defined as a hospital discharge code for CHF or systolic dysfunction requiring a loop diuretic. We matched CHF cases with controls for gender and age at diabetes diagnosis. Logistic regression was used to model CHF using updated mean HbA1c during the study period and age, gender and diabetes duration as covariates. CHF incidence date was determined within the study period: October 1999- August 2011. Cox’ regression examined the link between HbA1c and time to CHF onset.
Out of 8 890 diabetic individuals, 759 developed CHF during the study period (mean age 74.2 ±9.6 yrs, 60.6% males). The OR for developing CHF with updated mean HbA1c>6.9% was 2.26 (95% CI 1.73, 2.95, p<0.01). Intensive glycemic control, i.e. HbA1c<6%, also appeared to increase the risk of developing CHF (OR 2.48, 95% CI 1.56, 3.95, p<0.01). There was a parallel relationship between HbA1c and time to CHF onset in diabetic patients.
Our data suggest glycemic control is an independent risk factor for incident CHF in diabetics. Both intensive glycemic control and chronic hyperglycemia appear to hasten CHF onset.
Oral Contributions South, Room 102
Saturday, March 09, 2013, 9:00 a.m.-9:15 a.m.
Session Title: Heart Failure Pathogenesis and Therapy
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 905-7
- 2013 American College of Cardiology Foundation