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Differences between diabetics and non-diabetics with chronic heart failure and its impact on prognosis

Session Poster Session 1

Speaker Lenka Spinarova

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : L Spinarova (Brno,CZ), J Spinar (Brno,CZ), J Parenica (Brno,CZ), M Spinarova (Brno,CZ), O Ludka (Brno,CZ), K Labr (Brno,CZ), F Malek (Praha,CZ), P Ostadal (Praha,CZ), J Jarkovsky (Brno,CZ)

Authors:
L Spinarova1 , J Spinar2 , J Parenica2 , M Spinarova1 , O Ludka2 , K Labr1 , F Malek3 , P Ostadal3 , J Jarkovsky4 , 1Masaryk University,St. Anne's Faculty Hospital,1st Department of Internal Medicine-Cardioangiology - Brno - Czechia , 2University Hospital and Masaryk university, Internal Cardiologic Dpt - Brno - Czechia , 3Homolka Hospital, Cardiologic Dpt - Praha - Czechia , 4Masaryk University, Faculty of Medicine, Institute for Biostatistics and Analysis - Brno - Czechia ,

Citation:

The FAR NHL (FARmacology and NeuroHumoraL activation) registry is a database of patients treated in 3 departments with specialized heart failure care in one country. The patients should be treated for systolic heart failure (EF < 50%) and stable for at least one month. It analyses physical status, laboratory tests :blood count, biochemistry, including NT-proBNP, echocardiography and concomitant medication.  Continuous variables are described by median, categorical variables are described by absolute and relative frequencies.P-value of Mann-Whitney U test for continuous variables and P-value of the Fisher’s exact test for categorical variables are reported for comparison of patients’ characteristics according to presence diabetes mellitus. Survival was evaluated after 2 years  of follow-up and defined  as freedom of death or left ventricle assist device  implantation or heart transplantation.

1052 patients were included, and divided to diabetics 409 and non-diabetics 643.  Patients with diabetes were older: 67 (60; 73) vs 64 years (54; 72) ( p< 0.001), had higher BMI 30 (27; 34) vs 28 (25; 31) ( p< 0.001),  higher heart rate 74 (65; 81) vs 71 (64; 80) ( p< 0.01), higher uric acid 412 (351; 477) vs 388 µmol/l (330; 463) ( p< 0.003), lower hemoglobin 141 (130; 151) vs 145 (133; 154) g/l (< 0.001) and lower glomerular filtration 63 (47; 82) vs 73 (57; 89) (ml/min/1.73 m²) (< 0.001). Diabetics had more often ischemic heart disease 70.9 vs 47.3 % ( p< 0.001), hypertension 79.7 vs 55.8%  ( p< 0.001), dyslipidemia 89.0 vs 69.2%  ( p< 0.001). The NT-proBNP levels were signifficantly higher in diabetics 681 (225; 1 708) vs 463 (138; 1 462) ng/l  in non- diabetics (p< 0.003). There were no differences in blood pressure, ejection fraction or presence of atrial fibrillation. Medication for heart failure did not differ in usage of ACEI/ARB, beta blockers and verospiron. Diabetics had more often furosemide 85.8 vs 77.3% (< 0.001). Two year survival was 81.2% in diabetics (77.2; 85.3) vs 86.1% in non- diabetics (83.3; 88.9) p< 0.057.

Conclusion: Diabetics have more often comorbidities: ischemic heart disease, hypertension, dyslipidemia, decreased renal functions and anemia, which contributes to more severe heart failure evaluated by NT-proBNP and  worse prognosis than in non- diabetics with chronic heart failure.

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