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 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

Hyperinsulinemia as an Independent Risk Factor for Ischemic Heart Disease

1996 ◽  
Vol 334 (15) ◽  
pp. 952-958 ◽  
Author(s):  
Jean-Pierre Després ◽  
Benoît Lamarche ◽  
Pascale Mauriège ◽  
Bernard Cantin ◽  
Gilles R. Dagenais ◽  
...  
Keyword(s):  
Risk Factor ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Independent Risk Factor ◽  
Ischemic Heart

P3544Role of cardiovascular comorbidities in heart failure across the ejection fraction spectrum

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Settergren ◽  
G Savarese ◽  
T Thorvaldsen ◽  
A Meyers ◽  
S Fazeli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Cox Regression ◽  
Nyha Class ◽  
Ischemic Heart ◽  
Similar Distribution ◽  
Reduced Ejection Fraction ◽  
Cardiovascular Comorbidities

Abstract Background Comorbidities are associated with heart failure (HF) development, severity and outcomes, but may play different roles in HF with preserved (HFpEF) vs. mid-range (HFmrEF) vs. reduced ejection fraction (HFrEF). A detailed characterization of HF patients according to EF and comorbidities may improve prognostication and facilitate trial design. Purpose To investigate characteristics and outcomes in a large and unselected cohort of HF patients according to EF strata and presence/absence of concomitant type 2 diabetes (T2DM), atrial fibrillation (AF) and chronic kidney disease (CKD). Methods Patients enrolled in the Swedish HF registry between 2000–2012 were considered. Kaplan Meier curves and multivariable Cox regression models were fitted to assess risk and predictors of outcomes (HF and all-cause hospitalization; composite of cardiovascular (CV) death and HF hospitalization). Results Of 42,583 patients (23% HFpEF, 21% HFmrEF, 56% HFrEF), 24% had T2DM, 49% CKD defined as eGFR&lt;60 ml/min/1.73m2, and 56% AF. T2DM, AF and CKD coexisted in 8% of the population with similar distribution across all EF strata. AF and CKD were the most likely to coexist. Prevalence of AF and/or CKD was highest in HFpEF and lowest in HFrEF, whereas prevalence of T2DM was similar across the EF spectrum (Figure). Compared to patients without T2DM and/or AF and/or CKD, those with any of them were more likely to suffer from other comorbidities (i.e. hypertension, anemia, COPD), to be inpatients, have more severe HF (higher NYHA class, NT-proBNP levels and use of diuretics, longer HF duration) but less likely to be followed-up in specialty vs. primary care. Concomitant history of ischemic heart disease was more likely in patients with vs. without CKD and/or T2DM but less likely in those with vs without AF. Patients with vs. without T2DM and/or CKD and/or AF had worse prognosis. In particular, risk of HF hospitalization and composite of HF hospitalization/CV death was highest in patients with HFrEF and concomitant comorbidities, whereas the risk of all-cause hospitalization was highest in those with HFpEF or HFmrEF and concomitant comorbidities. Prognostic predictors of CV death/HF hospitalization were consistent in patients with T2DM, CKD or AF, regardless of EF (e.g. male sex, older age, lower EF category, more severe HF, ischemic heart disease, anemia, COPD). Comorbidities burden Conclusion HF patients show a high burden of concomitant diseases, specifically T2DM, CKD and AF. CKD and AF are more prevalent in HFpEF vs. HFmrEF vs. HFrEF, whereas T2DM prevalence is consistent across the EF spectrum. Presence of comorbidities identifies patients with more severe HF regardless of EF category. Presence of comorbidities may identify patients at higher risk of CV outcomes in HFrEF and those at higher risk of non-CV events in HFpEF. Acknowledgement/Funding This study has been supported by funding from Boehringer Ingelheim

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.

Psoriasis as an Independent Risk Factor for Cardiovascular Disease

2015 ◽  
Vol 20 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Yi Chun Lai ◽  
Yik Weng Yew
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Independent Risk Factor ◽  
Ischemic Heart

Background: Psoriasis is known to be associated with metabolic syndrome, a well-established risk factor for ischemic heart disease and stroke. Emerging evidence indicates that psoriasis is an independent risk factor for cardiovascular disease and stroke. Objective: To evaluate whether psoriasis is independently associated with myocardial infarction (MI), ischemic heart disease (MI, angina pectoris, or coronary heart disease), and stroke, we conducted a cross-sectional study using the US National Health and Nutrition Examination Survey (NHANES) database. Methods: Data on clinical history of psoriasis, MI, angina pectoris, coronary heart disease, and stroke from the questionnaire as well as laboratory parameters on serum lipid and uric acid levels in the cycle years 2003-2006 and 2009-2012 were analyzed. Multivariate analysis with logistic regression modelling was performed with the aforementioned cardiovascular events or stroke as the dependent variables and with risk factors such as age, gender, ethnic group, current smoking status, alcohol consumption, metabolic syndrome, hyperuricemia, and psoriasis as independent variables. Results: There were 520 cases of psoriasis, and 108 of them had metabolic syndrome (20.8%). Well-established cardiovascular risk factors such as age, gender, ethnic group, smoking, alcohol consumption, metabolic syndrome, and hyperuricemia were also found to have significant associations with MI and ischemic heart disease (all P values <.001). Psoriatic patients were at significantly higher risks of developing MI (odds ratio [OR] 2.24; 95% CI: 1.27-3.95; P = .005) and ischemic heart disease (OR 1.90; 95% CI: 1.18-3.05; P = .008), but not stroke (OR 1.01; 95% CI: 0.48-2.16; P = .744), after adjustment was made for major cardiovascular risk factors. Conclusion: This study provides epidemiological evidence that psoriasis may be independently associated with the development of MI and ischemic heart disease. Physicians should be cognizant of any underlying cardiovascular risk factors, especially among psoriatic patients with metabolic syndrome, and manage them according to national guidelines.

scholarly journals Is Lipoprotein(a) an Independent Risk Factor for Ischemic Heart Disease in Men? The Quebec Cardiovascular Study

1998 ◽  
Vol 31 (3) ◽  
pp. 519-525 ◽  
Author(s):  
Bernard Cantin ◽  
France Gagnon ◽  
Sital Moorjani ◽  
Jean-Pierre Després ◽  
Benoit Lamarche ◽  
...  
Keyword(s):  
Risk Factor ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Independent Risk Factor ◽  
Ischemic Heart ◽  
Lipoprotein A
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