scholarly journals Incidence of heart failure among diabetic patients with ischemic heart disease: a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Senbeta Guteta Abdissa ◽  
Wakgari Deressa ◽  
Amit J. Shah
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Diabetic Patients

scholarly journals Incidence of Heart Failure among Diabetic Patients with Ischemic Heart Disease: A Cohort Study

2020 ◽  
Author(s):  
Senbeta Guteta Abdissa ◽  
Wakgari Deressa ◽  
Amit J Shah
Keyword(s):  
Heart Failure ◽  
Risk Factor ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Addis Ababa ◽  
Ischemic Heart ◽  
Diabetic Patients

Abstract Background: In population studies of heart failure (HF), diabetes has been shown to be an independent risk factor. However, the evidence evaluating diabetes mellitus (DM) as an independent risk factor in incident HF in patients with ischemic heart disease (IHD) is scarce. Our study aimed to assess the incidence of HF in diabetic IHD patients compared to non-diabetic IHD patients in Ethiopia.Methods: A retrospective cohort study was conducted among 306 patients with IHD followed-up at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The IHD patients who did not have HF at baseline were followed for 24 months beginning from November 30, 2015. We assessed the incidence of HF in patients with diabetic IHD versus the non-diabetic IHD. Cox proportional hazards models were used to assess the association between diabetic IHD and HF after controlling for important covariates. Hypertension was examined as a possible effect modifier as well.Results: The mean age was 56.8 years, 69% were male, and 31% were diabetic. During the 24 months follow-up period, 196 (64.1%) had incident HF. On multivariate Cox regression, DM was significantly associated with incident HF [Hazard Ratio = 2.04, 95% confidence interval (CI): 1.32-3.14, p = 0.001]. Furthermore, when the patients were stratified by hypertension (HTN), DM was associated with worse prognosis, the strongest association being in those with co-existing DM and HTN [HR = 2.57,95% CI =1.66-3.98, p<0.0001] followed by the presence of DM without HTN [HR 2.27, 95% CI = 1.38-3.71, p=0.001] (compared to those with neither). Conclusion: DM is the strongest predictor of incident HF, compared to other traditional risk factors, in Ethiopian patients with IHD. Those with both DM and HTN are at the highest risk.

scholarly journals Incidence of Heart Failure among Diabetic Patients with Ischemic Heart Disease: A Cohort Study

2019 ◽  
Author(s):  
Senbeta Guteta Abdissa ◽  
Wakgari Deressa ◽  
Amit Shah
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Addis Ababa ◽  
Cox Proportional Hazards ◽  
Ischemic Heart ◽  
Diabetic Patients

Abstract Background In population studies of heart failure (HF), diabetes was shown to be an independent risk factor but the evidence regarding Diabetes Mellitus (DM) having incremental effect in incidence of HF in patients with ischemic heart disease (IHD) is scarce. Our study aimed to assess the incidence of HF in diabetic IHD patients compared to non-diabetic IHD patients. Methods A retrospective cohort study was conducted among 306 patients with IHD followed-up at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The IHD patients who did not have HF at baseline were followed for 24 months beginning from November 30, 2015. We assessed the incidence of HF in patients with diabetic IHD versus the non-diabetic IHD. Cox proportional hazards models were used to assess the association between diabetic IHD and HF after controlling for important covariates. Results Mean age was 56.8 years and male patients accounted for 69%. Prevalence of DM was 31.4% (n=96). During the 24 months follow-up period, 196 (64.1%) had incident HF. Predictors of incident HF were female sex [COR 2.2(1.3-3.8), p=0.006], DM [COR 1.8 (1.1-3.0), p = .04], older age [t (304) = 2.5, p = 0.01, two tailed], bigger left atrial size [t (196) = 2.9, p = 0.005, two-tailed], and lower hemoglobin [t (232) = - 2.3, p = 0.02, two-tailed]. On multivariate Cox regression, DM was significantly associated with incident HF [Hazard Ratio = 2.04, 95% CI: 1.32-3.14, p = 0.001]. Furthermore, when the patients were stratified by hypertension (HTN), DM was associated with worse prognosis, the strongest association being in those with co-existing DM and HTN [HR = 2.57,95% CI =1.66-3.98, p<0.0001] followed by the presence of DM without HTN [HR 2.27, 95% CI = 1.38-3.71, p=0.001]. Conclusion DM is the strongest predictor of incident HF in patients with IHD. It is worse when DM is combined with HTN.

scholarly journals Predictive Factors on the Incidence of Heart Failure in Patients with Ischemic Heart Disease: Using a 10-Year Population-Based Korea National Health Insurance Cohort Data

2020 ◽  
Vol 17 (22) ◽  
pp. 8670
Author(s):  
Seon Young Hwang ◽  
Kyung Ae Kim ◽  
Oh Jong Choi
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Health Insurance ◽  
Ischemic Heart Disease ◽  
National Health Insurance ◽  
National Health ◽  
Ischemic Heart ◽  
Rank Test ◽  
Diabetic Patients ◽  
Men And Women

Early risk stratification and preventative strategies are required in patients with ischemic heart disease (IHD) to prevent heart failure (HF). We aimed to investigate the rate of progression to HF and to investigate the factors predicting the development of HF in a population with IHD for 10 years. A descriptive study was conducted using Korea National Health Insurance Service-National Sample Cohort (NHI-NSC) data (2005–2015). Among the patients diagnosed with IHD for the first time in 2005–2006, 2271 men and 2037 women who responded to the health check-up survey were finally selected. Cox Proportional Hazard regression analyses and the Kaplan–Meier survival analysis were used. HF incidence rates were 5.1% in men and 8.0% in women. The mean duration of transition to HF was 4.85 ± 2.73 years in men and 4.73 ± 2.73 years in women. The non-incidence rate of HF was higher in men than in women (Log-rank test, p = 0.0003). Bivariate analyses showed that older age, prevalence of hypertension and diabetes, less alcohol, and lower physical exercise were associated with the incidence of HF in both men and women. Multivariate analyses found that HF incidence in aged subjects ≥70 years was 1.46 times higher in men and 1.44 times higher in women compared to those in their 30 s (p < 0.001). Prevalence of hypertension reduced the incidence of HF by 0.78 and 0.87 for men and women, respectively. The prevalence of diabetes increased 1.23 times only in men. These findings suggest that special attention such as periodic counseling and education is needed to prevent progression to HF in elderly and diabetic patients during follow-up after IHD.

scholarly journals Incidence of Heart Failure among Diabetic Patients with Ischemic Heart Disease: A Cohort Study

2020 ◽  
Author(s):  
Senbeta Guteta Abdissa ◽  
Wakgari Deressa ◽  
Amit J Shah
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Risk Factor ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Ischemic Heart

Abstract Background: In population studies of heart failure (HF), diabetes mellitus (DM) has been shown to be an independent risk factor. However, the evidence evaluating it as an independent risk factor in incident HF in patients with ischemic heart disease (IHD) is scarce. Our study aimed to assess the incidence of HF in diabetic IHD patients compared to non-diabetic IHD patients in Ethiopia. Methods: A retrospective cohort study was conducted among 306 patients with IHD followed-up at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The IHD patients who did not have HF at baseline were followed for 24 months beginning from November 30, 2015. We assessed the incidence of HF in patients with diabetic IHD versus the non-diabetic IHD. Cox proportional hazards models were used to assess the association between diabetic IHD and HF after controlling for important covariates. Hypertension was examined as a possible effect modifier as well. Results: The mean age was 56.8 years, 69% were male, and 31% were diabetic. During the 24 months follow-up period, 196 (64.1%) had incident HF. On multivariate Cox regression, DM was significantly associated with incident HF [Hazard Ratio = 2.04, 95% confidence interval (CI): 1.32-3.14, p = 0.001]. Furthermore, when the patients were stratified by hypertension (HTN) status, DM was associated with worse prognosis, and the strongest association was in those with co-existing DM and HTN [HR = 2.57,95% CI =1.66-3.98, p<0.0001], followed by the presence of DM without HTN [HR 2.27, 95% CI = 1.38-3.71, p=0.001] (compared to those with neither). Conclusion: DM is the strongest predictor of incident HF, compared to other traditional risk factors, in Ethiopian patients with IHD. Those with both DM and HTN are at the highest risk. Key Words: Ischemic heart disease; Heart failure; Incidence; Diabetes Mellitus; Retrospective cohort study

Abstract 14943: Comparison of Heart Failure Patients Newly Prescribed Sacubitril/valsartan With Those Newly Prescribed Aceis/arbs; A Cohort Study Using Us Optum Electronic Health Record Data

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Emil Loefroth ◽  
Xian Shen ◽  
Rachel Studer ◽  
Raymond Schlienger ◽  
Clare Proudfoot ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Similar Proportion ◽  
Resynchronization Therapy

Background: The clinical development program of sacubitril/valsartan (sac/val) for heart failure with reduced ejection fraction (HFrEF) only included a very limited number of patients being naive to prior angiotensin converting enzyme inhibitors (ACEis) or angiotensin II receptor antagonists (ARBs). Recent studies support the use of sac/val in hospitalised HF patients without prior ACEis/ARBs. This study aims to compare HF patients newly prescribed either sac/val or ACEis/ARBs. Methods: Retrospective non-interventional cohort study describing two mutually exclusive adult patient cohorts diagnosed with HFrEF either initiating sac/val or ACEis/ARBs. All patients were naive to both sac/val and ACEis/ARBs for 12 months prior to the first prescription. All patients had a left ventricular ejection fraction (LVEF) ≤40%. Patients were identified any time between 1 st July 2015 and 31 st Dec 2018 in the Optum® de-identified EHR dataset from providers across the continuum of care. Results: 2,414 patients were initiated on sac/val, 36,563 on ACEis/ARBs. Mean age was 66.1 (SD 12.9) and 67.2 years (SD 13.7) for sac/val and ACEis/ARBs users, respectively. Sac/val patients were more likely to be male: 70.8% vs 67.2% (p<0.0001) and had a lower mean LVEF: 26.9% vs 29.3% (p<0.0001). Patients newly initiated on sac/val had similar proportion of ischemic heart disease (67.9% vs 68.2%, p=0.72), and more often valvular heart disease (48.6% vs 44.3%, p<0.0001), and use of cardio resynchronization therapy device (40.9% vs 24.0%, p<0.0001). Conclusions: This real-world study indicates that sac/val tends to be newly prescribed to younger, male HFrEF patients with lower LVEF and a higher proportion of cardio resynchronization therapy devices compared with patients newly initiated on ACEis/ARBs. The prevalence of ischemic heart disease is similar between the groups.

scholarly journals Short-term and one-year prognosis of diabetic patients with a first-ever myocardial infarction

Medicina ◽  
2007 ◽  
Vol 43 (7) ◽  
pp. 555 ◽  
Author(s):  
Lina Jančaitytė ◽  
Daiva Rastenytė
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Acute Heart Failure ◽  
Female Gender ◽  
Ischemic Heart ◽  
Diabetic Patients ◽  
Risk Of Death ◽  
One Year

Objectives. To clarify the importance of clinical features and changes in the first electrocardiogram in 28-day and 1-year mortality in patients with diabetes. Material and methods. Men and women of Kaunas city aged 25–64 years with the first-ever myocardial infarction during 1983–1992 and with the first electrocardiogram were enrolled in the study. Electrocardiograms were coded using the WHO MONICA Project Protocol criteria and the Minnesota Code. The Kaunas Ischemic Heart Disease Register was the source of data; deaths from ischemic heart disease were identified via death register. Results. Diabetes was diagnosed in 124 patients: 65 (52.4%) men and 59 (47.6%) women. The 28-day (P=0.01) and 1-year mortality rates (P<0.001) were higher in diabetic than in nondiabetic patients with myocardial infarction. Among diabetic patients, who died during 28 days or one year, myocardial infarction was more often complicated by acute heart failure, and changes in ECG were more often detected than among those who were alive. Female gender (RR=30.2, P=0.02) was associated with an increased risk of death from a first-ever myocardial infarction during the first 28 days, while acute heart failure (RR=4.48, P=0.01) and anterior location of Q wave in the first ECG (RR=2.71, P=0.04) increased the risk of death from ischemic heart disease during one year after a first-ever myocardial infarction. Conclusions. Acute heart failure and Q-wave in derivations of the first electrocardiogram reflecting anterior site of myocardial infarction increased the risk of death from ischemic heart disease during the first year, and female gender – during the first 28 days in diabetic patients with myocardial infarction.

scholarly journals Risk of heart disease following breast cancer: results from a population-based cohort study

2021 ◽  
Author(s):  
Haomin Yang ◽  
Nirmala Bhoo Pathy ◽  
Judith Brand ◽  
Elham Hedayati ◽  
Felix Grassmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cancer Patients ◽  
Time Dependent ◽  
Ischemic Heart ◽  
Breast Cancer Patients ◽  
Increased Risk

BACKGROUND: There is a rising concern about treatment-associated cardiotoxicities in breast cancer patients.<br />OBJECTIVES?This study aimed to determine the time- and treatment-specific incidence of arrhythmia, heart failure and ischemic heart disease in women diagnosed with breast cancer.<br /> METHODS: A register-based matched cohort study was conducted including 8338 breast cancerpatients diagnosed from 2001-2008 in the Stockholm-Gotland region and followed-up until 2017. Overall and time dependent risks of arrhythmia, ischemic heart disease and heart failure in breast cancer patients were assessed using flexible parametric models as compared to matched controls from general population. Treatment-specific effects were estimated in breast cancer patients using Cox model.<br />RESULTS: During a median follow-up of 10.8 years, the hazard ratios for arrhythmia, heart failure and ischemic heart disease, were 1.27 (95% CI = 1.18-1.37), 1.38 (95% CI = 1.23-1.55), and 0.93 (95% CI = 0.84-1.03), respectively. Time-dependent analyses revealed long-term increased risks of arrhythmia, and heart failure in breast cancer patients compared to matched controls. The risk of ischemic heart disease was only elevated in the first year after cancer diagnosis. Trastuzumab and anthracyclines were associated with increased risk of heart failure. Aromatase inhibitors, but not tamoxifen, were associated with risk of ischemic heart disease. No increased risk of heart disease was identified following loco-regional radiotherapy.<br />CONCLUSIONS: Administration of systemic adjuvant therapies appear to be associated with increased risks of heart disease. The risk estimates observed in this study may serve as reference to aid adjuvant therapy decision-making and patient counseling in oncology practices.

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