Diabetes mellitus in patients with heart failure and reduced ejection fraction : a post hoc analysis from the WARCEF trial
© 2024. The Author(s)..
Patients with heart failure with reduced ejection fraction (HFrEF) and diabetes mellitus (DM) have an increased risk of adverse events, including thromboembolism. In this analysis, we aimed to explore the association between DM and HFrEF using data from the "Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction" (WARCEF) trial. We analyzed factors associated with DM using multiple logistic regression models and evaluated the effect of DM on long-term prognosis, through adjusted Cox regressions. The primary outcome was the composite of all-cause death, ischemic stroke, or intracerebral hemorrhage; we explored individual components as the secondary outcomes and the interaction between treatment (warfarin or aspirin) and DM on the risk of the primary outcome, stratified by relevant characteristics. Of 2294 patients (mean age 60.8 (SD 11.3) years, 19.9% females) included in this analysis, 722 (31.5%) had DM. On logistic regression, cardiovascular comorbidities, symptoms and ethnicity were associated with DM at baseline, while age and body mass index showed a nonlinear association. Patients with DM had a higher risk of the primary composite outcome (Hazard Ratio [HR] and 95% Confidence Intervals [CI]: 1.48 [1.24-1.77]), as well as all-cause death (HR [95%CI]: 1.52 [1.25-1.84]). As in prior analyses, no statistically significant interaction was observed between DM and effect of Warfarin on the risk of the primary outcome, in any of the subgroups explored. In conclusion, we found that DM is common in HFrEF patients, and is associated with other cardiovascular comorbidities and risk factors, and with a worse prognosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Internal and emergency medicine - (2024) vom: 23. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Romiti, Giulio Francesco [VerfasserIn] |
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| Links: |
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| Themen: |
Diabetes mellitus |
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| Anmerkungen: |
Date Revised 23.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s11739-024-03544-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368834840 |
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| 100 | 1 | |a Romiti, Giulio Francesco |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diabetes mellitus in patients with heart failure and reduced ejection fraction |b a post hoc analysis from the WARCEF trial |
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| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a Patients with heart failure with reduced ejection fraction (HFrEF) and diabetes mellitus (DM) have an increased risk of adverse events, including thromboembolism. In this analysis, we aimed to explore the association between DM and HFrEF using data from the "Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction" (WARCEF) trial. We analyzed factors associated with DM using multiple logistic regression models and evaluated the effect of DM on long-term prognosis, through adjusted Cox regressions. The primary outcome was the composite of all-cause death, ischemic stroke, or intracerebral hemorrhage; we explored individual components as the secondary outcomes and the interaction between treatment (warfarin or aspirin) and DM on the risk of the primary outcome, stratified by relevant characteristics. Of 2294 patients (mean age 60.8 (SD 11.3) years, 19.9% females) included in this analysis, 722 (31.5%) had DM. On logistic regression, cardiovascular comorbidities, symptoms and ethnicity were associated with DM at baseline, while age and body mass index showed a nonlinear association. Patients with DM had a higher risk of the primary composite outcome (Hazard Ratio [HR] and 95% Confidence Intervals [CI]: 1.48 [1.24-1.77]), as well as all-cause death (HR [95%CI]: 1.52 [1.25-1.84]). As in prior analyses, no statistically significant interaction was observed between DM and effect of Warfarin on the risk of the primary outcome, in any of the subgroups explored. In conclusion, we found that DM is common in HFrEF patients, and is associated with other cardiovascular comorbidities and risk factors, and with a worse prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diabetes mellitus | |
| 650 | 4 | |a HFrEF | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Prognosis | |
| 700 | 1 | |a Nabrdalik, Katarzyna |e verfasserin |4 aut | |
| 700 | 1 | |a Corica, Bernadette |e verfasserin |4 aut | |
| 700 | 1 | |a Bucci, Tommaso |e verfasserin |4 aut | |
| 700 | 1 | |a Proietti, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Qian, Min |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yineng |e verfasserin |4 aut | |
| 700 | 1 | |a Thompson, John L P |e verfasserin |4 aut | |
| 700 | 1 | |a Homma, Shunichi |e verfasserin |4 aut | |
| 700 | 1 | |a Lip, Gregory Y H |e verfasserin |4 aut | |
| 700 | 0 | |a WARCEF Investigators |e verfasserin |4 aut | |
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