Effects of diabetes mellitus and ischemic heart disease on the progression from asymptomatic left ventricular dysfunction to symptomatic heart failure: A retrospective analysis from the Studies of Left Ventricular Dysfunction (SOLVD) Prevention Trial - 26/08/11
, Mark H. Drazner, MD, MSc a, Clyde W. Yancy, MD a, Lynne W. Stevenson, MD b, Bernard J. Gersh, MB, ChB, DPhil c, Daniel L. Dries, MD, MPH aAbstract |
Background |
Emerging data suggest that diabetes mellitus is a risk factor for the progression of established heart failure only in those patients with ischemic cardiomyopathy. Whether diabetes mellitus is a risk factor for the progression from asymptomatic left ventricular systolic dysfunction to symptomatic heart failure in patients with left ventricular dysfunction of an ischemic cause is not known.
Methods |
We performed a retrospective analysis of 2821 patients with asymptomatic left ventricular systolic dysfunction from the Studies of Left Ventricular Dysfunction (SOLVD) Prevention trial. We used adjusted survival analysis to examine the effects of ischemic heart disease and diabetes mellitus on 3 prespecified study end points: (1) development of heart failure (HF) symptoms, (2) HF hospitalization, and (3) death or development of symptoms.
Results |
There is a statistically significant interaction between the cause of left ventricular systolic dysfunction and diabetes mellitus on the risk of development of heart failure symptoms (P = .020). Patients with ischemic cardiomyopathy and diabetes had an increased risk of progression to symptomatic heart failure (HR = 1.56, P < .001), hospitalization for heart failure (HR = 2.16, P < .001), and death or development of symptoms (HR = 1.50, P < .001), compared with patients with ischemic cardiomyopathy without diabetes. In contrast, diabetes was not associated with an increased risk of reaching these end points in patients with nonischemic cardiomyopathy.
Conclusions |
Diabetes mellitus is a risk factor for the progression from asymptomatic left ventricular systolic dysfunction to symptomatic heart failure, but this risk appears to be confined to those patients with ischemic cardiomyopathy.
Le texte complet de cet article est disponible en PDF.Plan
Vol 148 - N° 5
P. 883-888 - novembre 2004 Retour au numéro
Article précédent
- Impact of short-term intermittent intravenous dobutamine therapy on endothelial function in patients with severe chronic heart failure
- Dov Freimark, Micha S. Feinberg, Shlomi Matezky, Naomi Hochberg, Michael Shechter
- Impact of angiotensin-converting enzyme gene polymorphism on neurohormonal responses to high- versus low-dose enalapril in advanced heart failure
- W.H.Wilson Tang, Randall H. Vagelos, Yin-Gail Yee, Michael B. Fowler
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?