Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –

Miura, Masanobu; Sakata, Yasuhiko; Miyata, Satoshi; Nochioka, Kotaro; Takada, Tsuyoshi; Tadaki, Soichiro; Ushigome, Ryoichi; Yamauchi, Takeshi; Sato, Kenjiro; Onose, Takeo; Tsuji, Kiichiro; Abe, Ruri; Takahashi, Jun; Shimokawa, Hiroaki

doi:10.1253/circj.cj-15-0096

Cited by 14 publications

(15 citation statements)

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“…We and others have previously shown the prognostic impacts of DM and albuminuria in CHF patients 12,[26][27][28][29] (Table 4). In fact, patients with NGR and albuminuria had higher event rate than in those with IGT or DM without albuminuria, suggesting that albuminuria has more prognostic impact than glycaemic abnormalities in CHF patients.…”

Section: Prognostic Implications Of Impaired Glucose Tolerance and DImentioning

confidence: 74%

“…In fact, patients with NGR and albuminuria had higher event rate than in those with IGT or DM without albuminuria, suggesting that albuminuria has more prognostic impact than glycaemic abnormalities in CHF patients. We and others have previously shown the prognostic impacts of DM and albuminuria in CHF patients 12,[26][27][28][29] (Table 4). A previous study showed that albuminuria was associated with poor prognosis in CHF patients.…”

Section: Prognostic Significance Of Albuminuria In Chronic Heart Failmentioning

confidence: 74%

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Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

et al. 2019

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AimsThe study aims to evaluate the prognostic significance of impaired glucose tolerance (IGT) with reference to albuminuria in patients with chronic heart failure (CHF). Methods and resultsWe examined 535 CHF patients (mean 66years, women 25%) in the control arm of our SUPPORT trial, in which we examined additive impact of olmesartan in hypertensive patients with symptomatic CHF treated with β-blockers and/ or angiotensin-converting enzyme inhibitors. We examined the association between glycaemic abnormality (assessed by 75g of oral glucose tolerance test) and albuminuria for a composite outcome of all-cause death, myocardial infarction, stroke, and HF hospitalization. IGT patients (N=113, mean 67.2years) were older and more frequently treated with β-blockers compared with those with normal glucose regulation (N=142, mean 64.0years) and those with diabetes mellitus (N=280, mean 65.7years). Multivariable Cox proportional hazard models revealed that, as compared with normal glucose regulation (NGR), IGT was associated with increased risk of the outcome when complicated by albuminuria [hazard ratio (HR) 2.25; 95% confidence interval (CI) 1.14-4.42; P=0.019] but not when uncomplicated by albuminuria (HR 0.76; 95% CI 0.35-1.60, P=0.47) (P for interaction= 0.041). This was also the case for diabetes mellitus and albuminuria (HR 2.06; 95% CI 1.17-3.61; P=0.012). Among IGT patients without albuminuria, 21 (29%) developed albuminuria at 1-year visit, which was again associated with poor prognosis (HR 7.36; 95% CI 1.39-38.98, P=0.019). Conclusions These results indicate that IGT is associated with poor prognosis when complicated by albuminuria in CHF patients, demonstrating the importance of combined early stages of glucose intolerance and renal dysfunction in the management of CHF.

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Section: Prognostic Implications Of Impaired Glucose Tolerance and DImentioning

confidence: 74%

Section: Prognostic Significance Of Albuminuria In Chronic Heart Failmentioning

confidence: 74%

Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

et al. 2019

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“…CHART‐2 data that support the findings of this study are available from the corresponding author on reasonable request. The CHART‐2 study has been described in detail previously . Briefly, CHART‐2 (n=10219) is a multicenter, prospective, observational cohort study designed to identify the characteristics, mortality, and prognostic risks of patients with a history of HF and those without HF but at high risk of HF in Japan .…”

Section: Methodsmentioning

confidence: 99%

“…The CHART‐2 study has been described in detail previously . Briefly, CHART‐2 (n=10219) is a multicenter, prospective, observational cohort study designed to identify the characteristics, mortality, and prognostic risks of patients with a history of HF and those without HF but at high risk of HF in Japan . From October 2006 to March 2010, 10219 consecutive stable patients at outpatient clinics or just before discharge aged >20 years were successfully enrolled in CHART‐2 if they had stage B, C, or D HF or significant coronary artery disease in stage A, as defined according to the ACC/AHA guidelines .…”

Section: Methodsmentioning

confidence: 99%

Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

Oikawa

Sakata

Nochioka

et al. 2018

JAHA

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BackgroundThe beneficial prognostic impact of statins has been established in patients with ischemic heart disease but not in those with heart failure (HF). In addition, it is still unclear whether patients benefit from statins regardless of low‐density lipoprotein cholesterol levels.Methods and ResultsWe examined 2444 consecutive stage C or D HF patients with ischemic heart disease registered in CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2), a multicenter, prospective, observational cohort study in Japan. Patients were divided into 3 groups according to the Japanese standard doses of statins and statin‐intensity categories defined by the 2013 American College of Cardiology and American Heart Association guidelines: higher (moderate‐high)‐intensity (n=868), lower (low)‐intensity (n=526), and no statin (n=1050). The median follow‐up period was 6.4 years (13929 person‐years). Analysis with the inverse probability of treatment weighted using a propensity score for multiple treatment revealed that both the higher‐intesity group (hazard ratio [HR]: 0.68; P<0.001) and the lower‐intensity group (HR: 0.82; P<0.001) had significantly lower incidence of the primary end point—a composite of all‐cause death and HF admission—compared with the no statin group. The higher‐intensity statin group had significantly lower incidence of the primary end point (HR: 0.82; P<0.001), all‐cause death (HR: 0.83; P<0.001), and HF admission (HR: 0.78; P<0.001) than the lower‐intensity statin group. Moreover, the use of statins, either higher‐ or lower‐intensity, was associated with reduced incidence of the primary end point, regardless of low‐density lipoprotein cholesterol levels.ConclusionsThese results suggest that statin use, particularly the use of higher‐intensity statins, has a beneficial prognostic impact in HF patients with ischemic heart disease, regardless of low‐density lipoprotein cholesterol levels.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00418041.

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“…4 It is well known that CKD is an independent risk factor for HF and exacerbates the progression of cardiac dysfunction as well as atherosclerosis (Figure 1). Furthermore, anemia, a strong prognostic marker in HF, 11 is commonly concomitant with CKD.…”

Section: Article P 1764mentioning

confidence: 99%

Lessons and Perspectives on Heart Failure Management From Considerations Based on the CHART-2 Study

Sato

2015

Circ J

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Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –

Cited by 14 publications

References 32 publications

Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

Lessons and Perspectives on Heart Failure Management From Considerations Based on the CHART-2 Study

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Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease – With Special Reference to Nephropathy –

Cited by 14 publications

References 32 publications

Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial

Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

Lessons and Perspectives on Heart Failure Management From Considerations Based on the CHART-2 Study

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Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease　– With Special Reference to Nephropathy –