Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure

A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial

Marco Dauriz, Giovanni Targher, Pier Luigi Temporelli, Donata Lucci, Lucio Gonzini, Gian Luigi Nicolosi, Roberto Marchioli, Gianni Tognoni, Roberto Latini, Franco Cosmi, Luigi Tavazzi, Aldo Pietro Maggioni, T. Moccetti, M. G. Rossi, E. Pasotti, F. Vaghi, P. Roncarolo, M. T. Zunino, F. Matta, E. Actis Perinetto & 31 others F. Gaita, G. Azzaro, M. Zanetta, A. M. Paino, U. Parravicini, D. Vegis, R. Conte, P. Ferraro, A. De Bernardi, S. Morelloni, M. Fagnani, P. Greco Lucchina, L. Montagna, E. Bellone, D. Sappè, F. Ferraro, M. Delucchi, S. G. Reynaud, M. Dore, A. La Brocca, N. Massobrio, L. Bo, R. Trinchero, M. Imazio, G. Brocchi, A. Nejrotti, L. Rissone, S. Gabasio, C. Zocchi, Jay N. Cohn, on behalf of the GISSI-HF Investigators

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background-The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. Methods and Results-We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01-1.29, respectively). Conclusions-Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure.

Original languageEnglish (US)
Article numbere005156
JournalJournal of the American Heart Association
Volume6
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Prediabetic State
Diabetes Mellitus
Heart Failure
Cause of Death
Survival
Registries
Hemoglobins
Hospitalization
Randomized Controlled Trials
Regression Analysis
Outcome Assessment (Health Care)
Incidence

Keywords

  • Chronic heart failure
  • Diabetes mellitus
  • Glycemic control
  • Heart failure
  • Mortality
  • Prediabetes

Cite this

Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure : A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. / Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro; Moccetti, T.; Rossi, M. G.; Pasotti, E.; Vaghi, F.; Roncarolo, P.; Zunino, M. T.; Matta, F.; Actis Perinetto, E.; Gaita, F.; Azzaro, G.; Zanetta, M.; Paino, A. M.; Parravicini, U.; Vegis, D.; Conte, R.; Ferraro, P.; De Bernardi, A.; Morelloni, S.; Fagnani, M.; Greco Lucchina, P.; Montagna, L.; Bellone, E.; Sappè, D.; Ferraro, F.; Delucchi, M.; Reynaud, S. G.; Dore, M.; La Brocca, A.; Massobrio, N.; Bo, L.; Trinchero, R.; Imazio, M.; Brocchi, G.; Nejrotti, A.; Rissone, L.; Gabasio, S.; Zocchi, C.; Cohn, Jay N.; on behalf of the GISSI-HF Investigators.

In: Journal of the American Heart Association, Vol. 6, No. 7, e005156, 01.07.2017.

Research output: Contribution to journalArticle

Dauriz, M, Targher, G, Temporelli, PL, Lucci, D, Gonzini, L, Nicolosi, GL, Marchioli, R, Tognoni, G, Latini, R, Cosmi, F, Tavazzi, L, Maggioni, AP, Moccetti, T, Rossi, MG, Pasotti, E, Vaghi, F, Roncarolo, P, Zunino, MT, Matta, F, Actis Perinetto, E, Gaita, F, Azzaro, G, Zanetta, M, Paino, AM, Parravicini, U, Vegis, D, Conte, R, Ferraro, P, De Bernardi, A, Morelloni, S, Fagnani, M, Greco Lucchina, P, Montagna, L, Bellone, E, Sappè, D, Ferraro, F, Delucchi, M, Reynaud, SG, Dore, M, La Brocca, A, Massobrio, N, Bo, L, Trinchero, R, Imazio, M, Brocchi, G, Nejrotti, A, Rissone, L, Gabasio, S, Zocchi, C, Cohn, JN & on behalf of the GISSI-HF Investigators 2017, 'Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure: A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial', Journal of the American Heart Association, vol. 6, no. 7, e005156. https://doi.org/10.1161/JAHA.116.005156
Dauriz, Marco ; Targher, Giovanni ; Temporelli, Pier Luigi ; Lucci, Donata ; Gonzini, Lucio ; Nicolosi, Gian Luigi ; Marchioli, Roberto ; Tognoni, Gianni ; Latini, Roberto ; Cosmi, Franco ; Tavazzi, Luigi ; Maggioni, Aldo Pietro ; Moccetti, T. ; Rossi, M. G. ; Pasotti, E. ; Vaghi, F. ; Roncarolo, P. ; Zunino, M. T. ; Matta, F. ; Actis Perinetto, E. ; Gaita, F. ; Azzaro, G. ; Zanetta, M. ; Paino, A. M. ; Parravicini, U. ; Vegis, D. ; Conte, R. ; Ferraro, P. ; De Bernardi, A. ; Morelloni, S. ; Fagnani, M. ; Greco Lucchina, P. ; Montagna, L. ; Bellone, E. ; Sappè, D. ; Ferraro, F. ; Delucchi, M. ; Reynaud, S. G. ; Dore, M. ; La Brocca, A. ; Massobrio, N. ; Bo, L. ; Trinchero, R. ; Imazio, M. ; Brocchi, G. ; Nejrotti, A. ; Rissone, L. ; Gabasio, S. ; Zocchi, C. ; Cohn, Jay N. ; on behalf of the GISSI-HF Investigators. / Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure : A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 7.
@article{e09621c46b9046039fe863240f23eab8,
title = "Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure: A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial",
abstract = "Background-The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. Methods and Results-We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5{\%} versus 24.6{\%}) and the composite end point (63.6{\%} versus 54.7{\%}). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95{\%} CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95{\%} CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95{\%} CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95{\%} CI, 1.01-1.29, respectively). Conclusions-Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure.",
keywords = "Chronic heart failure, Diabetes mellitus, Glycemic control, Heart failure, Mortality, Prediabetes",
author = "Marco Dauriz and Giovanni Targher and Temporelli, {Pier Luigi} and Donata Lucci and Lucio Gonzini and Nicolosi, {Gian Luigi} and Roberto Marchioli and Gianni Tognoni and Roberto Latini and Franco Cosmi and Luigi Tavazzi and Maggioni, {Aldo Pietro} and T. Moccetti and Rossi, {M. G.} and E. Pasotti and F. Vaghi and P. Roncarolo and Zunino, {M. T.} and F. Matta and {Actis Perinetto}, E. and F. Gaita and G. Azzaro and M. Zanetta and Paino, {A. M.} and U. Parravicini and D. Vegis and R. Conte and P. Ferraro and {De Bernardi}, A. and S. Morelloni and M. Fagnani and {Greco Lucchina}, P. and L. Montagna and E. Bellone and D. Sapp{\`e} and F. Ferraro and M. Delucchi and Reynaud, {S. G.} and M. Dore and {La Brocca}, A. and N. Massobrio and L. Bo and R. Trinchero and M. Imazio and G. Brocchi and A. Nejrotti and L. Rissone and S. Gabasio and C. Zocchi and Cohn, {Jay N.} and {on behalf of the GISSI-HF Investigators}",
year = "2017",
month = "7",
day = "1",
doi = "10.1161/JAHA.116.005156",
language = "English (US)",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Prognostic impact of diabetes and prediabetes on survival outcomes in patients with chronic heart failure

T2 - A post-hoc analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial

AU - Dauriz, Marco

AU - Targher, Giovanni

AU - Temporelli, Pier Luigi

AU - Lucci, Donata

AU - Gonzini, Lucio

AU - Nicolosi, Gian Luigi

AU - Marchioli, Roberto

AU - Tognoni, Gianni

AU - Latini, Roberto

AU - Cosmi, Franco

AU - Tavazzi, Luigi

AU - Maggioni, Aldo Pietro

AU - Moccetti, T.

AU - Rossi, M. G.

AU - Pasotti, E.

AU - Vaghi, F.

AU - Roncarolo, P.

AU - Zunino, M. T.

AU - Matta, F.

AU - Actis Perinetto, E.

AU - Gaita, F.

AU - Azzaro, G.

AU - Zanetta, M.

AU - Paino, A. M.

AU - Parravicini, U.

AU - Vegis, D.

AU - Conte, R.

AU - Ferraro, P.

AU - De Bernardi, A.

AU - Morelloni, S.

AU - Fagnani, M.

AU - Greco Lucchina, P.

AU - Montagna, L.

AU - Bellone, E.

AU - Sappè, D.

AU - Ferraro, F.

AU - Delucchi, M.

AU - Reynaud, S. G.

AU - Dore, M.

AU - La Brocca, A.

AU - Massobrio, N.

AU - Bo, L.

AU - Trinchero, R.

AU - Imazio, M.

AU - Brocchi, G.

AU - Nejrotti, A.

AU - Rissone, L.

AU - Gabasio, S.

AU - Zocchi, C.

AU - Cohn, Jay N.

AU - on behalf of the GISSI-HF Investigators

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background-The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. Methods and Results-We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01-1.29, respectively). Conclusions-Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure.

AB - Background-The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. Methods and Results-We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01-1.29, respectively). Conclusions-Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure.

KW - Chronic heart failure

KW - Diabetes mellitus

KW - Glycemic control

KW - Heart failure

KW - Mortality

KW - Prediabetes

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U2 - 10.1161/JAHA.116.005156

DO - 10.1161/JAHA.116.005156

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JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

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