| Heart failure severity, as determined by loop diuretic dosages, predicts the risk of developing diabetes after myocardial infarction: a nationwide cohort study. | |
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MedLine Citation:
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PMID: 20864482 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Heart failure (HF) is associated with increased insulin resistance, but the consequences of HF for development of diabetes are not well studied. The aim of the present study was to investigate the relationship between HF severity and risk of developing diabetes in a nationwide cohort of patients with myocardial infarction (MI). METHODS AND RESULTS: Patients discharged from first-time MI during 1997-2006 and not previously treated with glucose-lowering medications (GLM) or loop diuretics were identified from Danish nationwide registers. Heart failure severity was determined by loop diuretic dosage after discharge. Patients were followed until first claimed prescription of GLM, death, or until the end of 2006. The cohort comprised 50 874 patients. A total of 3006 (6%) had mild (loop-diuretic dosage≤40 mg/day), 5383 (11%) moderate (>40-120 mg/day), and 1127 (2%) severe (>120 mg/day) HF. During follow-up, 2531 (5%) patients developed diabetes. Increasing HF severity was associated with increased risk of diabetes, but the use of renin-angiotensin system inhibitors (RASi) attenuated the risk (P-value for interaction between the HF group and RASi<0.05). Compared with no HF, the adjusted hazard ratios (95% confidence interval) for the development of diabetes were 1.34 (1.11-1.63), 1.63 (1.40-1.90), and 1.68 (1.25-2.25) for mild, moderate, and severe HF with RASi treatment; and 1.45 (1.13-1.88), 1.90 (1.56-2.33), and 3.02 (2.01-4.54) for mild, moderate, and severe HF without RASi treatment. CONCLUSION: Heart failure predicts the development of diabetes in a severity-dependent manner among patients with MI. Focus on increased predisposition to diabetes is warranted and needs further investigations. |
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Authors:
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Charlotte Andersson; Mette L Norgaard; Peter R Hansen; Emil L Fosbøl; Michelle Schmiegelow; Peter Weeke; Jonas B Olesen; Jakob Raunsø; Casper H Jørgensen; Allan Vaag; Lars Køber; Christian Torp-Pedersen; Gunnar H Gislason |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-23 |
Journal Detail:
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Title: European journal of heart failure Volume: 12 ISSN: 1879-0844 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-06-02 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1333-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, DK 2900 Hellerup, Denmark. ca@heart.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cohort Studies Confidence Intervals Denmark / epidemiology Diabetes Mellitus / epidemiology*, etiology Female Health Status Indicators Heart Failure / complications, drug therapy*, mortality, pathology Humans Incidence Kaplan-Meier Estimate Male Middle Aged Myocardial Infarction / complications* Prevalence Prognosis Proportional Hazards Models Renin-Angiotensin System / drug effects Risk Risk Assessment Severity of Illness Index Sodium Potassium Chloride Symporter Inhibitors / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Sodium Potassium Chloride Symporter Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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