Role of diabetes in congestive heart failure: The Framingham study

Kannel, William B.; Hjortland, Marthana C.; Castelli, William P.

doi:10.1016/0002-9149(74)90089-7

Cited by 1,852 publications

(1,131 citation statements)

References 12 publications

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“…6 , September 1983 of myocardial decompensation were compared with the diabetic patients who did not have these manifestations. This observation adds some support to the suggestion by Kannel et al (1974) that the higher frequency of myocardial decompensation in diabetic patients may be a result of factors other than the extent of disease in the macroscopic coronary arteries. Kannel reported that the excess risk of heart failure in diabetic patients may be confined to those treated with insulin.…”

supporting

confidence: 85%

Coronary artery disease in diabetic and nondiabetic patients: A clinical and angiographic comparison

Wilson

Gau

Fulton

et al. 1983

Clinical Cardiology

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Summary:A comparison of data from 58 diabetic and 58 nondiabetic patients with arteriographic evidence of coronary artery disease showed that diabetic patients had a significantly greater frequency of major stenoses in the intermediate coronary artery segments but no significant differences in, the proximal or distal segments. Thus, the diabetic patients did have more severe coronary disease, but the diabetic group did not have "more distal" disease as represented by the number of major or minor lesions in the distal segments. The diabetic patients had a significantly greater frequency of electrocardiographic intraventricular conduction defects and manifestations of left ventricular dysfunction. There was no significant difference in the severity of coronary artery disease between the diabetic patients with manifestations of myocardial decompensation and the diabetic patients without such manifestations, suggesting that the in- and Internal Medicine creased frequency of myocardial dysfunction in diabetic patients may be related to factors other than the greater severity of coronary artery disease.

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supporting

confidence: 85%

Coronary artery disease in diabetic and nondiabetic patients: A clinical and angiographic comparison

Wilson

Gau

Fulton

et al. 1983

Clinical Cardiology

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“…If hypertensive heart disease and heart failure were to have been considered with IHD the SMRs would have been virtually unchanged in the under 40 age groups and slightly diminished (but still raised) in the 40 to 84 age groups. A high frequency of congestive heart failure among young women with diabetes was noted more than a quarter of a century ago in the Framingham Study [23]. Although this is attributed to specific diabetic cardiomyopathy by some, it is regarded by many as a complication of IHD [24].…”

Section: Discussionmentioning

confidence: 99%

Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes

Laing

Swerdlow

Slater³

et al. 2003

Diabetologia

640

407

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Aims/hypothesis. Although ischaemic heart disease is the predominant cause of mortality in older people with diabetes, age-specific mortality rates have not been published for patients with Type 1 diabetes. The Diabetes UK cohort, essentially one of patients with Type 1 diabetes, now has sufficient follow-up to report all heart disease, and specifically ischaemic heart disease, mortality rates by age. Methods. A cohort of 23,751 patients with insulintreated diabetes, diagnosed under the age of 30 years and from throughout the United Kingdom, was identified during the period 1972 to 1993 and followed for mortality until December 2000. Age-and sex-specific heart disease mortality rates and standardised mortality ratios were calculated. Results. There were 1437 deaths during the follow-up, 536 from cardiovascular disease, and of those, 369 from ischaemic heart disease. At all ages the ischaemic heart disease mortality rates in the cohort were higher than in the general population. Mortality rates within the cohort were similar for men and women under the age of 40. The standardised mortality ratios were higher in women than men at all ages, and in women were 44.8 (95%CI 20.5-85.0) at ages 20-29 and 41.6 (26.7-61.9) at ages 30-39. Conclusions/interpretation. The risk of mortality from ischaemic heart disease is exceptionally high in young adult women with Type 1 diabetes, with rates similar to those in men with Type 1 diabetes under the age of 40. These observations emphasise the need to identify and treat coronary risk factors in these young patients. [Diabetologia (2003) 46:760-765]

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“…However, despite the existence of a significant association between hyperglycemia and adverse clinical outcomes in patients with HF,9, 13, 14, 15 no recommendations to identify specific glycemic goals or high‐risk patient groups have been provided so far, mainly because of the lack of compelling evidence on the benefit of universally achieving a strict glycemic control 16. Additionally, randomized, clinical trials that have explored the cardiovascular safety of the newer hypoglycemic drugs did not find any clear benefit on the risk of HF in patients with DM at high cardiovascular risk, except for opposite effects of empagliflozin (positive) and saxagliptin (negative) on the risk of HF hospitalization 17, 18, 19…”

Section: Introductionmentioning

confidence: 99%

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

Dauriz

Targher

Temporelli

et al. 2017

JAHA

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BackgroundThe 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 ResultsWe 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).ConclusionsPresence 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.

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Role of diabetes in congestive heart failure: The Framingham study

Cited by 1,852 publications

References 12 publications

Coronary artery disease in diabetic and nondiabetic patients: A clinical and angiographic comparison

Coronary artery disease in diabetic and nondiabetic patients: A clinical and angiographic comparison

Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes

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

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