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Tytuł pozycji:

Prognostic impact of HbA1c variability on long-term outcomes in patients with heart failure and type 2 diabetes mellitus

Tytuł :
Prognostic impact of HbA1c variability on long-term outcomes in patients with heart failure and type 2 diabetes mellitus
Autorzy :
Wang, Chang-qian
Gu, Jun
Pan, Jian-an
Fan, Yu-qi
Zhang, Hui-li
Zhang, Jun-feng
Pokaż więcej
Temat :
Heart failure
RC666-701
Hospitalization
Diseases of the circulatory (Cardiovascular) system
Original Investigation
Type 2 diabetes mellitus
Mortality
Hemoglobin A1c variability
Źródło :
Cardiovascular Diabetology, Vol 17, Iss 1, Pp 1-11 (2018)
Cardiovascular Diabetology
Wydawca :
BioMed Central, 2018.
Rok publikacji :
2018
Oryginalny identyfikator :
pmc: PMC6026342
pmid: 29960591
96
Język :
English
ISSN :
1475-2840
DOI :
10.1186/s12933-018-0739-3
Background The prognostic impact of long-term glycemic variability on clinical outcomes in patients with heart failure (HF) and type 2 diabetes mellitus (T2DM) remains unclear. We determined and compared hemoglobin A1c (HbA1c) variability and clinical outcomes for patients with HF with preserved ejection fraction (HFpEF), HF with mid-range ejection fraction (HFmrEF) and HF with reduced ejection fraction (HFrEF) in a prospective longitudinal study. Methods Patients with HF and T2DM, undergone 3 or more HbA1c determinations during the first 18 months, were then followed for 42 months. The primary outcome was death from any cause. Secondary outcome was composite endpoints with death and HF hospitalization. Cox proportional hazards models were used to compare outcomes for patients with HFpEF, HFmrEF and HFrEF. Results Of 902 patients enrolled, 32.2% had HFpEF, 14.5% HFmrEF, and 53.3% HFrEF. During 42 months of follow-up, 270 (29.9%) patients died and 545 (60.4%) patients experienced composite endpoints of death and HF readmission. The risk of all-cause death or composite endpoints was lower for HFpEF than HFrEF. Moreover, higher HbA1c variability was associated with higher all-cause mortality or composite endpoints and HbA1c variability was an independent predictor of all-cause mortality or composite endpoints, regardless of EF. Conclusions This prospective longitudinal study showed that the all-cause death and composite events was lower for HFpEF than HFrEF. HbA1c variability was independently and similarly predictive of death or combined endpoints in the three HF phenotypes. Electronic supplementary material The online version of this article (10.1186/s12933-018-0739-3) contains supplementary material, which is available to authorized users.
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