Impact of diabetes on outcomes in patients with low and preserved ejection fraction heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme

CHARM Investigators, Michael R MacDonald, Mark C Petrie, Fumi Varyani, Jan Ostergren, Eric L Michelson, James B Young, Scott D Solomon, Christopher B Granger, Karl Swedberg, Salim Yusuf, Marc A Pfeffer, John J V McMurray

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: To determine whether the risk of adverse cardiovascular (CV) outcomes associated with diabetes differs in patients with low and preserved ejection fraction (EF) heart failure (HF).

METHODS AND RESULTS: We analysed outcomes in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme which randomized 7599 patients with symptomatic HF and a broad range of EF. The prevalence of diabetes was 28.3% in patients with preserved EF (>40%) and 28.5% in those with low EF (<or=40%). Diabetes was associated with a greater relative risk of CV death or HF hospitalization in patients with preserved EF [hazard ratio (HR) 2.0 (1.70-2.36)] than in patients with low EF [HR 1.60 (1.44-1.77); interaction test P = 0.0009]. For all-cause mortality, the risk conferred by diabetes was similar in both low and preserved EF groups. The effect of candesartan in reducing CV morbidity and mortality outcomes was not modified by having diabetes at baseline (P = 0.09 test for interaction).

CONCLUSION: Diabetes was an independent predictor of CV morbidity and mortality in patients with HF, regardless of EF. The relative risk of CV death or HF hospitalization conferred by diabetes was significantly greater in patients with preserved when compared with those with low EF HF.

Original languageEnglish
Pages (from-to)1377-85
Number of pages9
JournalEuropean Heart Journal
Volume29
Issue number11
DOIs
Publication statusPublished - Jun 2008

Keywords

  • Aged
  • Angiotensin II Type 1 Receptor Blockers
  • Benzimidazoles
  • Diabetic Angiopathies
  • Epidemiologic Methods
  • Female
  • Heart Failure
  • Humans
  • Male
  • Prognosis
  • Stroke Volume
  • Tetrazoles
  • Treatment Outcome

Fingerprint

Dive into the research topics of 'Impact of diabetes on outcomes in patients with low and preserved ejection fraction heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme'. Together they form a unique fingerprint.

Cite this