Diabetes Tied to Faster Progression to Overt Heart Failure
Diabetes, especially when uncontrolled, is strongly associated with progression to overt heart failure in patients with preclinical signs of heart failure. The study included 4774 adults (mean age 75 years, 58% women, 20% Black) with preclinical heart failure, 1551 in stage A and 3223 in stage B, and 30% of the study population had diabetes.

Within each heart failure stage, associations were assessed between diabetes and glycemic control with progression to heart failure. The primary outcome was a new diagnosis of definite or probable acute decompensated heart failure or the development of chronic stable heart failure. During a median follow-up of 7.5 years there were 470 heart failure events.

Results showed that diabetes was associated with progression to heart failure (with a younger age of heart failure onset and a shorter time to event) and increased heart failure risk across stages A and B. There were significantly higher absolute and relative risks related to diabetes among individuals in stage B, as compared with persons with diabetes in stage A. Patients with diabetes and stage B heart failure had at least four times the absolute risk of developing overt heart failure than those in stage A without diabetes.

Uncontrolled diabetes (A1c > 7%) was associated with a higher risk of incident heart failure for individuals in both stage A and B. Compared with individuals without diabetes and in preclinical stage A, those in preclinical stage B with uncontrolled diabetes had a 7.6-fold higher risk of incident heart failure. Those in stage B with controlled diabetes had a 4.6-fold increased risk of incident heart failure and those in stage A with uncontrolled diabetes had a 1.5-fold increased risk.

Source: https://www.medscape.com/viewarticle/975122?src=rss