Background: It has been shown a strong influence of ATG polymorphism on heart failure development. However, the impact of M235T polymorphism of ATG on cardiovascular events development in diabetic patients with heart failure with preserved ejection fraction (HFpEF) is still unknown.
Aim: To estimate whether M235T polymorphism of ATG is associated with cardiovascular events in diabetic patients with heart failure with HFpEF.
Methods: A total of eighty-two patients (50 females and 32 males; mean age 62,9±8,1 years) with HFpEF and type 2 diabetes mellitus were examined. Sixty-two patients were carriers of 235T allele (MT+TT genotypes), 20 patients had MM genotype of M235T polymorphism of ATG, which was determined by using of polymerase chain reaction. The pre-defined composite endpoint of cardiovascular events includes cardiac death, hospitalization for heart failure, non-fatal stroke. The Kaplan-Meier method and the log-rank statistic for survival curves evaluation were used.
Results: 40 (48%) patients had the study composite endpoint after mean follow-up of two years. Survival curves showed higher level of cardiovascular events occurrence in patients carrying MT and TT genotypes compared with MM carriers (p=0.01) (Fig.1). In a Cox hazards survival model, the presence of the MT+TT genotypes in diabetic patients with HFpEF was associated independently with higher hazard ratio compared with carriers of MM genotypes (OR 10.30, 95% CI [2.72–39.08], p<0.005).
Conclusion: MT+TT genotypes of M235T polymorphism of ATG were independently associated with worse cardiovascular prognosis in diabetic patients with HFpEF