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Impact of Diabetes on Epidemiology, Treatment, and Outcomes of Patients With Heart Failure
Open accessAbstract
The prevalence of patients with concomitant heart failure (HF) and diabetes mellitus (DM) continues to increase with the general aging of the population. In patients with chronic HF, prevalence of DM is 24% compared with 40% in those hospitalized with worsening HF. Patients with concomitant HF and DM have diverse pathophysiologic, metabolic, and neurohormonal abnormalities that potentially contribute to worse outcomes than those without comorbid DM. In addition, although stable HF outpatients with DM show responses that are similar to those of patients without DM undergoing evidence-based therapies, it is unclear whether hospitalized HF patients with DM will respond similarly to novel investigational therapies. These data support the need to re-evaluate the epidemiology, pathophysiology, and therapy of HF patients with concomitant DM. This paper discusses the role of DM in HF patients and underscores the potential need for the development of targeted therapies.
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“Since the report of the Framingham Heart study, type 2 diabetes (T2DM) has been known to increase the incidence of HF up to more than double with respect to non-affected individuals, with the growing awareness that this complication may develop independently of coronary artery disease (CAD) and associated risk factors [8,9,10,11].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [10]
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“Importantly, eplerenone seems to have no effect on new-onset T2DM in patients with HF, suggesting a neutral metabolic profile.160”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [160]
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Leon, B. M. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i13.1246 · Cited by 1,215
Clinical Update: Cardiovascular Disease in Diabetes Mellitus
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“Reduced SERCA2a activity and consequent calcium overload in the cytosol can cause impaired relaxation as well as altered calcium sensitivity of proteins involved in regulation of the cardiac actomysin system and shifting of cardiac myosin heavy chain isoforms from V1 to V3, which can lead to reduced contractile force.…”
InfluentialSeferović, P. M., Petrie, M. C., Filippatos, G. S., Anker, S. D., Rosano, G., Bauersachs, J., Paulus, W. J., Komajda, M., Cosentino, F., de Boer, R. A., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1170 · Cited by 708
Self-citationHeart Failure in Type 2 Diabetes Mellitus
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“Patients with diabetes mellitus have over twice the risk of developing HF than patients without diabetes mellitus.(5,6) The Framingham Heart Study suggests that diabetes mellitus independently increases the risk of HF up to 2-fold in men and 5-fold in women compared with age-matched controls,(7,8) highlighting a sex d…”
BackgroundDunlay, S. M., Givertz, M. M., Aguilar, D., Allen, L. A., Chan, M., Desai, A. S., Deswal, A., Dickson, V. V., Kosiborod, M. N., Lekavich, C. L., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000691 · Cited by 639
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Metadata
- Authors
- Dei Cas, A., Khan, S. S., Butler, J., Mentz, R. J., Bonow, R. O., Avogaro, A., Tschoepe, D., Doehner, W., Greene, S. J., Senni, M., Gheorghiade, M., & Fonarow, G. C.
- Affiliations
- Northwestern University (US)
- Stony Brook University (US)
- Duke Medical Center (US)
- University of Padua (IT)
- University Hospitals of the Ruhr-University of Bochum (DE)
- Center for Stroke Research Berlin (DE)
- Ospedale Papa Giovanni XXIII (IT)
- University of California, Los Angeles (US)
- Corresponding author
- Fonarow, Gregg C.
- ORCID
- Venue
- JACC Heart Failure
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 3
- Issue
- 2
- Pages
- 136-145
- ISSN
- 2213-1779 (ISSN-L)
- OpenAlex
- W2072535229
- Cited by
- 401
- References
- 59
- Citations by year
- 2026: 8 · 2025: 28 · 2024: 33 · 2023: 17 · 2022: 55 · 2021: 69 · 2020: 55 · 2019: 31 · 2018: 40 · 2017: 20 · 2016: 26 · 2015: 19
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Funders
- Amgen
- Boston Scientific Corporation
- National Institutes of Health
- Agency for Healthcare Research and Quality
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- heart failure, diabetes mellitus, comorbidities, prevalence, pathophysiology, metabolic abnormalities, treatment outcomes, targeted therapy
- MeSH terms
- Adrenergic beta-Antagonists, Angiotensin-Converting Enzyme Inhibitors, Autonomic Nervous System Diseases, Diabetes Mellitus, Diuretics, Fatty Acids, Nonesterified, Heart, Heart Failure, Humans, Insulin Resistance, Mitochondria, Heart, Myocardium, Renin-Angiotensin System, Renal Insufficiency, Vascular Remodeling
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