Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2‐year adverse outcomes. Data from the FARNHL registry.

Labr, Karel; Spinar, Jindrich; Parenica, Jiri; Spinarova, Lenka; Krejci, Jan; Malek, Filip; Ostadal, Petr; Ludka, Ondrej; Jarkovsky, Jiri; Benesova, Klara; Labrova, Ruzena; Spinarova, Monika

Background/Aim: The study aims to describe the role of diabetes in patients with heart failure. Methods: In all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month. Results: More than one‐third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (N = 409) were older (median 67 vs. 64, p < 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m2, p < 0.001), much more frequently had ischemic heart disease (71 vs. 47%, p < 0.001), hypertension (80 vs. 67%, p < 0.001), dyslipidemia (89 vs. 69%, p < 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m2, p < 0.001), and higher N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) (median 681 vs. 463 pg/mL, p = 0.003). All‐cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2‐year follow‐up. In the 2‐year follow‐up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (p = 0.089). DM is a statistically significant predictor of NT‐proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT‐proBNP level was high, the presence of DM did not influence the prognosis. Conclusion: The combination of diabetes and NT‐proBNP levels may better stratify the prognosis of patients with chronic heart failure.

HEART failure patients; MYOCARDIAL ischemia; CORONARY disease; PEOPLE with diabetes; GLOMERULAR filtration rate; HEART assist devices

Journal of Diabetes, 2024, Vol 16, Issue 9, p1

1753-0393

Academic Journal

10.1111/1753-0407.13605