Karel Labr, Jindrich Spinar, Jiri Parenica, Lenka Spinarova, Jan Krejci, Filip Malek, Petr Ostadal, Ondrej Ludka, Jiri Jarkovsky, Klara Benesova, Ruzena Labrova, Monika Spinarova
{"title":"稳定型慢性心力衰竭患者的糖尿病及其与体液激活的结合、两者之间的关联以及两年不良预后的预测。来自 FAR NHL 登记处的数据","authors":"Karel Labr, Jindrich Spinar, Jiri Parenica, Lenka Spinarova, Jan Krejci, Filip Malek, Petr Ostadal, Ondrej Ludka, Jiri Jarkovsky, Klara Benesova, Ruzena Labrova, Monika Spinarova","doi":"10.1111/1753-0407.13605","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background/Aim</h3>\n \n <p>The study aims to describe the role of diabetes in patients with heart failure.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>More than one-third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (<i>N</i> = 409) were older (median 67 vs. 64, <i>p</i> < 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m<sup>2</sup>, <i>p</i> < 0.001), much more frequently had ischemic heart disease (71 vs. 47%, <i>p</i> < 0.001), hypertension (80 vs. 67%, <i>p</i> < 0.001), dyslipidemia (89 vs. 69%, <i>p</i> < 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m<sup>2</sup>, <i>p</i> < 0.001), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) (median 681 vs. 463 pg/mL, <i>p</i> = 0.003). All-cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2-year follow-up. In the 2-year follow-up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (<i>p</i> = 0.089). DM is a statistically significant predictor of NT-proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT-proBNP level was high, the presence of DM did not influence the prognosis.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The combination of diabetes and NT-proBNP levels may better stratify the prognosis of patients with chronic heart failure.</p>\n \n <div>\n <figure>\n <div><picture>\n <source></source></picture><p></p>\n </div>\n </figure>\n </div>\n </section>\n </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13605","citationCount":"0","resultStr":"{\"title\":\"Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2-year adverse outcomes. 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Diabetic patients (<i>N</i> = 409) were older (median 67 vs. 64, <i>p</i> < 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m<sup>2</sup>, <i>p</i> < 0.001), much more frequently had ischemic heart disease (71 vs. 47%, <i>p</i> < 0.001), hypertension (80 vs. 67%, <i>p</i> < 0.001), dyslipidemia (89 vs. 69%, <i>p</i> < 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m<sup>2</sup>, <i>p</i> < 0.001), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) (median 681 vs. 463 pg/mL, <i>p</i> = 0.003). All-cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2-year follow-up. In the 2-year follow-up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (<i>p</i> = 0.089). DM is a statistically significant predictor of NT-proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT-proBNP level was high, the presence of DM did not influence the prognosis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The combination of diabetes and NT-proBNP levels may better stratify the prognosis of patients with chronic heart failure.</p>\\n \\n <div>\\n <figure>\\n <div><picture>\\n <source></source></picture><p></p>\\n </div>\\n </figure>\\n </div>\\n </section>\\n </div>\",\"PeriodicalId\":189,\"journal\":{\"name\":\"Journal of Diabetes\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13605\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13605\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13605","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2-year adverse outcomes. Data from the FAR NHL registry
Background/Aim
The study aims to describe the role of diabetes in patients with heart failure.
Methods
In all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month.
Results
More than one-third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (N = 409) were older (median 67 vs. 64, p < 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m2, p < 0.001), much more frequently had ischemic heart disease (71 vs. 47%, p < 0.001), hypertension (80 vs. 67%, p < 0.001), dyslipidemia (89 vs. 69%, p < 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m2, p < 0.001), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) (median 681 vs. 463 pg/mL, p = 0.003). All-cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2-year follow-up. In the 2-year follow-up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (p = 0.089). DM is a statistically significant predictor of NT-proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT-proBNP level was high, the presence of DM did not influence the prognosis.
Conclusion
The combination of diabetes and NT-proBNP levels may better stratify the prognosis of patients with chronic heart failure.
期刊介绍：
Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation.
The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.
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