Abstract Title:

An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure.

Abstract Source:

Am Heart J. 2006 Jan;151(1):91. PMID: 16368297

Abstract Author(s):

Shervin Eshaghian, Tamara B Horwich, Gregg C Fonarow

Article Affiliation:

Cedars Sinai Medical Center, Los Angeles, CA, USA.


BACKGROUND: In diabetes, poor glycemic control, as indexed by hemoglobin A1c (HbA1c), is associated with increased risk of cardiovascular events and new-onset heart failure (HF). However, in patients with diabetes and HF, the relationship between glucose control and survival has not been investigated. Our study aimed to evaluate the relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic HF. METHODS: We studied a cohort of 123 patients with diabetes and advanced systolic HF referred to a single center with HbA1c values measured at presentation. The patients were grouped based on HbA1c: HbA1c7.0 (n = 74). RESULTS: The cohort was 70% men, ejection fraction of 25% +/- 7, 59% ischemic etiology, HbA1c 7.9 +/- 1.8, and diabetes duration of 8.6 +/- 9.0 years. The HbA1c groups were similar in age; sex; New York Heart Association class; body mass index; diabetes duration; and insulin, metformin, and glitazone use. HbA1c>7.0 was associated with higher ejection fraction, increased beta-blocker, and sulfonlyurea use. Patients with HbA1c7.0 (35% vs 20%, hazard ratio 2.6, 95% CI 1.3-5.2, P<.01). In multivariate analysis, HbA1c

Study Type : Human Study

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