scholarly journals Risk prediction of chronic heart failure in patients with type 2 diabetes

2021 ◽  
Vol 7 (5) ◽  
pp. 19-27
Author(s):  
V. M. Vasilkova ◽  
T. V. Mokhort ◽  
I. G. Savasteeva ◽  
I. Yu. Pchelin ◽  
Yu. I. Yarets ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Medical Records ◽  
Predictive Power ◽  
Test Sample ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Factors Associated ◽  
Discriminant Power

<b>Introduction.</b> Diabetes mellitus and chronic heart failure (CHF) occur concomitantly, and each disease independently increases the risk for the other. In this connection, we studied the factors associated with CHF progression and proposed a mathematical model for assessing the prediction of the risk of CHF development, which can be applied in real clinical practice. <br><b>Patients and methods.</b> A total of 316 patients with DT2 were examined. The median age was 68 (63; 74) years. The levels of cystatin C, homocysteine, interleukin-6, and albumin/creatinine ratio were assessed in all patients with DT2. To evaluate the efficacy of this model, a retrospective analysis of patients’ medical records was carried out ("test sample"). The discriminant power (ROC) of the model in new cases of CHF was 0.91 (0.87; 1.00). Thus, it indicates a high predictive power of this method. <br><b>Results.</b> A model has been built to predict the likelihood of developing CHF in patients with DT2 (sensitivity 76.2%, specificity 73.3%). <br><b>Conclusions.</b> This model will allow for accurate prediction of the likelihood of developing CHF in patients with DT2. Further studies are needed to use it for choosing the optimal tactics for managing these patients.

scholarly journals Fibrosis biomarkers and echocardiographic parameters in patients with type 2 diabetes depending on the degree of albuminuria

2021 ◽  
Vol 20 (3) ◽  
pp. 72-78
Author(s):  
D. A. Lebedev ◽  
M. Yu. Laevskaya ◽  
A. Yu. Babenko
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Chronic Heart Failure ◽  
Urinary Albumin Excretion ◽  
Moderate Increase ◽  
Albumin Creatinine Ratio ◽  
Increased Risk ◽  
Galectin 3 ◽  
Echocardiographic Parameters

Background. Diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) is associated with a risk of developing chronic heart failure (CHF). The degree of albuminuria is a marker of DN and is associated with an increased risk of chronic heart failure (CHF).Aim. To evaluate fibrosis biomarkers and echocardiographic parameters in patients with T2DM without CHF, depending on urinary albumin excretion.Materials and methods. The study included 42 patients with T2DM without verified CHF. The patients were divided into two groups: 1) a group with normoalbuminuria and 2) a group with a moderate increase in albuminuria (albumin / creatinine ratio of 30–300 mg / g). Echocardiography was performed and galectin-3, ST-2, PIСP, MMP-9, and TIMP-1 concentrations were measured.Results. The groups did not differ by age, sex, body mass index (BMI), glycated hemoglobin (HbA1c), and glomerular filtration rate (GFR). Galectin-3 concentrations were significantly higher in the group with a moderate increase in albuminuria than in the group of patients without albuminuria – 13.6 (11.2; 15.1) ng / ml and 7.4 (6.7; 7.9) ng / ml, respectively, p = 0.002. The groups also did not differ in the values of biomarkers, such as P1CP, TIMP-1, and MMP-9. Besides, the group with normoalbuminuria had lower E/e’ values than the group with a moderate increase in albuminuria – 8 (7; 9) and 10 (9; 12.5), p = 0.02.Conclusion. The patients with type 2 diabetes and a moderate increase in albuminuria have higher values of galectin-3 and a more pronounced diastolic dysfunction. The identified changes may reflect a higher risk of chronic heart failure in this group of patients.

Prevalence, Incidence and Risk Factors of Chronic Heart Failure in the Type 2 Diabetic Population: Systematic Review

2009 ◽  
Vol 5 (3) ◽  
pp. 171-184 ◽  
Author(s):  
Linuo Zhou ◽  
Wei Deng ◽  
Lixue Zhou ◽  
Ping Fang ◽  
Daikun He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Systematic Review ◽  
Chronic Heart Failure ◽  
Diabetic Population ◽  
Type 2 Diabetic

scholarly journals Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

2018 ◽  
Vol 1 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Cystatin C ◽  
Early Treatment ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Serum Cystatin C ◽  
Albumin Creatinine Ratio

Background: Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects. Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 – 80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods. Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553]. Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

Клиническое значение результатов исследования DAPA HF (Dapagliflozin and prevention of adverse-outcomes in heart failure) для пациентов и врачей. Консенсус совета Экспертов

2021 ◽  
Vol 1 (223) ◽  
pp. 2-14
Author(s):  
Gulmira Alipova ◽  
◽  
Anna Bazarova ◽  
Nazira Bazarova ◽  
Rimma Bazarbekova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Persistent Symptoms

The article presents the results of the DAPA-HF study - evaluating the efficacy of dapagliflozin, used at a dose of 10 mg once a day, in addition to the standard treatment for patients with chronic heart failure with reduced left ventricular ejection fraction, compared to placebo. An analysis of current clinical recommendations related to this issue was carried out, the results of recent clinical studies and metaanalyses conducted were highlighted. Based on the results of the study, the need is postulated to optimize drug therapy of this category to patients with persistent symptoms of heart failure, despite standard therapy, with the addition of dapagliflozin to reduce the risk of cardiovascular death and hospitalizations for heart failure, improve the course of the disease. Keywords: chronic heart failure, dapagliflozin, low ejection fraction, effects of type 2 sodium-glucose co transporter inhibitors, diabetes mellitus.

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