Insulin treatment in heart failure patients: the good, the bad or the ugly?
| العنوان: | Insulin treatment in heart failure patients: the good, the bad or the ugly? |
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| المؤلفون: | Henrik Wiggers |
| المصدر: | Wiggers, H 2019, ' Insulin treatment in heart failure patients : the good, the bad or the ugly? ', European Journal of Heart Failure, vol. 21, no. 8 . https://doi.org/10.1002/ejhf.1556Test European Journal of Heart Failure |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Heart Failure, OUTCOMES, medicine.medical_specialty, business.industry, MORTALITY, Insulin, medicine.medical_treatment, Insulins, Stroke Volume, medicine.disease, Co‐morbidities, TYPE-2, Diabetes mellitus, Text mining, Heart failure, medicine, Humans, TRIAL, Cardiology and Cardiovascular Medicine, Intensive care medicine, business, GLUCOSE CONTROL, BASAL INSULIN, Research Article |
| الوصف: | Aims Insulin causes sodium retention and hypoglycaemia and its use is associated with worse outcomes in heart failure (HF) with reduced ejection fraction. We have investigated whether this is also the case in HF with preserved ejection fraction (HFpEF). Methods and results We examined the association between diabetes/diabetes treatments and the risk of the primary composite of cardiovascular death or HF hospitalization, as well as other outcomes in adjusted analyses in CHARM‐Preserved (left ventricular ejection fraction ≥ 45%), I‐Preserve and TOPCAT (Americas) pooled. Of 8466 patients, 2653 (31%) had diabetes, including 979 (37%) receiving insulin. Patients receiving insulin were younger, had a higher body mass index, prevalence of ischaemic aetiology, N‐terminal pro‐B‐type natriuretic peptide and use of diuretics, worse New York Heart Association class and signs and symptoms, and worse quality of life and renal function, compared to patients with diabetes not on insulin. Among the 1398 patients with echocardiographic data, insulin use was associated with higher left ventricular end‐diastolic pressure and more diastolic dysfunction than in other participants. The primary outcome occurred at a rate of 6.3 per 100 patient‐years in patients without diabetes, and 10.2 and 17.1 per 100 patient‐years in diabetes patients without and with insulin use, respectively [fully adjusted hazard ratio (aHR) insulin‐treated diabetes vs. other diabetes: 1.41, 95% confidence interval (CI) 1.23–1.63, P |
| تدمد: | 1879-0844 1388-9842 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd8704b4e3dc9e636a82be49e6872b38Test https://doi.org/10.1002/ejhf.1556Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....cd8704b4e3dc9e636a82be49e6872b38 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18790844 13889842 |
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