ADA: High Risk of Heart Failure
for Diabetics
People with type 2 diabetes have a higher risk
of heart failure with a poorer prognosis, researchers
report.
"Persons with type 2 diabetes live, with
an elevated risk of heart failure and that their
prognosis is worse than non-diabetics,"
That from Ruth Coleman, of the Oxford Centre
for Diabetes, Endocrinology and Metabolism, Diabetes
Trial Unit, Oxford, United Kingdom. "However
we haven't seen much rigorous analysis of data
from clinical research addressing this phenomena,"
she added. The information was presented, June
14th, in a poster presentation at the 63rd Annual
Meeting of the American Diabetes Association in
New Orleans.
The team of researchers evaluated data on 5,102
UK subjects from the United Kingdom Prospective
Diabetes Study (UKPDS), a prospective study undertaken
by the Oxford Centre. "Complete covariate
data was available on 4560 of the 5102 UKPDS patients.
Two hundred and forty three patients who had less
than 4 years follow-up were excluded, as were
299 with 1 or more missing data items," they
noted.
The investigators developed and applied an analytical
model including age, ethnicity and smoking status
at diabetes diagnosis, and measuring HbA1c, systolic
blood pressure (SBP), total and HDL cholesterol
values 1 to 2 years after diagnosis.
This "maximum likelihood analysis"
showed that age, HbA1c, SBP and duration of diabetes
were associated significantly with the risk of
heart failure (p<0.001) but not ethnicity,
sex, smoking at diagnosis, or ratio of total to
HDL cholesterol (p>0.2). Notably, they found
that, "127 (2.8%) patients developed left
ventricular or congestive cardiac failure during
median 10.6 years follow-up," which was statistically
significant ( p<0.001).
"This model, which can be used to assess
heart failure risk for individuals or populations
with type 2 diabetes, is being incorporated into
the UKPDS risk engine, a computer-based cardiovascular
risk calculator for type 2 diabetes," the
authors noted. [Study title: Risk of Heart Failure
in Type 2 Diabetes. Abstract 933-P]
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