Age affects the prognostic impact of diabetes in chronic heart failure

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Cunha, FM (Author) Other; Pereira, J (Author) Other; Ribeiro, A (Author) Other; Amorim, M (Author) Other; Silva, S (Author) Other; Araújo JP (Author) FMUP; Leite-Moreira AF (Author) FMUP; Bettencourt P (Author) FMUP; Lourenco, P (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: ACTA DIABETOLOGICA

Vol. 55

Pages: 271-278

ISSN: 0940-5429

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00N-P44

DOI: 10.1007/s00592-017-1092-9

Abstract (EN): Increasing age is an established prognostic determinant in chronic heart failure (HF). Diabetes often complicates HF in its course and appears to worsen HF prognosis. A differential impact of diabetes depending on patients' age was not yet studied. We evaluated the impact of diabetes in the mortality of HF patients according to their age. We studied a cohort of chronic ambulatory HF patients prospectively recruited. Patients were on optimized evidence-based therapy, and they were excluded if on renal replacement therapy or if they had any therapy modification or hospitalizations in the previous 2 months. Patients were followed for up to 5 years; all-cause mortality was analyzed. Mortality predictors were assessed using a Cox regression. Analysis was stratified according to patient's age: cutoff 75 years. Multivariate models were built. Interaction between diabetes and age was formally tested. We studied 283 chronic HF patients; mean age was 69 years and 70.3% were male; 58.0% had severe systolic dysfunction; 105 (37.1%) were diabetic. In patients with less than 75 years, the coexistence of diabetes predicted a multivariate adjusted 1.98 (95% CI 1.13-3.46) 5-year death risk while in older patients (ae<yen> 75 years) no significant association was reported. Age interacted with the prognostic impact of diabetes, p for interaction = 0.04. The prognostic impact of diabetes in chronic HF depends on patient's age. In patients < 75 years, the coexistence of diabetes predicts an almost double risk of 5-year mortality; no such association exists in patients with 75 years or above. Diabetes predicts mortality only in younger HF patients.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8