EHJ: Diabetes independently predicts cardiovascular death in HF patients

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Diabetes is an independent predictor of cardiovascular morbidity and mortality in patients with heart failure (HF), regardless of ejection fraction (EF), according to the CHARM program results published in the June issue of the European Heart Journal.

Michael R. MacDonald, BSc, Glasgow Royal Infirmary in Glasgow, Scotland, and colleagues set out to determine whether the risk of adverse cardiovascular outcomes associated with diabetes differs in heart failure patients with low and preserved EF.

The researchers analyzed outcomes in the CHARM (Candesartan in Heart failure—Assessment of Reduction in Mortality and morbidity) program, which randomized 7,599 patients with symptomatic HF and a broad range of EF. Among these patients, the prevalence of diabetes was 28.3 percent in patients with preserved EF ( >40 percent) and 28.5 percent in those with low EF (≤40 percent), the authors wrote.

The researchers reported that diabetes was associated with a greater relative risk of cardiovascular death or HF hospitalization in patients with preserved EF than in patients with low EF.

MacDonald and colleagues found that the risk conferred by diabetes was similar in both low and preserved EF groups for all-cause mortality. The effect of candesartan in reducing cardiovascular morbidity and mortality outcomes was not modified by having diabetes at baseline, according to the researchers.

Overall, the investigators found that the relative risk of cardiovascular death or HF hospitalization, conferred by diabetes, was significantly greater in patients with preserved when compared with those with low EF.