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Cited by 171Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsMenopause: Health Impacts and Treatments

Predictors of heart failure among women with coronary disease

Bibbins-Domingo, Kirsten, Lin, Feng, Vittinghoff, Eric, Barrett-Connor, Elizabeth, Hulley, Stephen B., Grady, Deborah, Shlipak, Michael G.·2004·Circulation
DOI 10.1161/01.cir.0000141726.01302.83
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Abstract

BACKGROUND: Although heart failure is common among women with coronary disease, the risk factors for developing heart failure have not been well studied. We determined the risk factors for developing heart failure among postmenopausal women with established coronary disease. METHODS AND RESULTS: This is a prospective cohort study using data from the Heart and Estrogen/progestin Replacement Study (HERS), a randomized, blinded, placebo-controlled trial of 4.1 years' duration, and subsequent open-label observational follow-up for 2.7 years (HERS II), performed at 20 US clinical centers between 1993 and 2000. Of the 2763 postmenopausal women with established coronary disease in the HERS trial, we studied the 2391 women with no heart failure at baseline by self-report and physical examination. The primary outcome of this analysis was incident heart failure defined by hospital admission or death from heart failure. During the 6.3+/-1.4-year follow-up, 237 women (10%) developed heart failure. Nine predictors were identified: diabetes (defined as a self-reported history of diabetes on treatment), atrial fibrillation, myocardial infarction, creatinine clearance <40 mL/min, systolic blood pressure >120 mm Hg, current smoking, body mass index >35 kg/m2, left bundle-branch block, and left ventricular hypertrophy. Randomization to estrogen/progestin was not associated with heart failure (hazard ratio=1.0; 95% CI, 0.7 to 1.3). Diabetes was the strongest risk factor (adjusted hazard ratio=3.1; 95% CI, 2.3 to 4.2). Diabetic women with elevated body mass index or depressed creatinine clearance were at highest risk, with annual incidence rates of 7% and 13%, respectively. Among diabetic women, hyperglycemia was associated with heart failure risk (adjusted hazard ratio=3.0; 95% CI, 1.2 to 7.5 for fasting glucose >300 mg/dL compared with fasting glucose 80 to 150 mg/dL). CONCLUSIONS: We identified 9 predictors of heart failure in postmenopausal women with coronary disease. Diabetes was the strongest risk factor, particularly when poorly controlled or with concomitant renal insufficiency or obesity.

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Authors
Bibbins-Domingo, K., Lin, F., Vittinghoff, E., Barrett-Connor, E., Hulley, S. B., Grady, D., & Shlipak, M. G.
Affiliations
San Francisco General Hospital (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-09-14
Volume
110
Issue
11
Pages
1424-1430
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000141726.01302.83
OpenAlex
W1995066509
Cited by
171
References
48
Citations by year
2025: 3 · 2024: 5 · 2023: 2 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 10 · 2018: 7 · 2017: 4 · 2016: 10 · 2015: 3 · 2014: 5 · 2013: 7 · 2012: 14
FWCI
6.75
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
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 › Menopause: Health Impacts and Treatments
Keywords
heart failure, coronary artery disease, postmenopausal women, risk factors, diabetes mellitus, hyperglycemia, renal failure, obesity, body mass index, atrial fibrillation, myocardial infarction, left bundle branch block, left ventricular hypertrophy, estrogen-progestin therapy, smoking, systolic blood pressure
MeSH terms
Aged, Atrial Fibrillation, Black or African American, Bundle-Branch Block, Coronary Disease, Diabetes Mellitus, Estrogens, Conjugated (USP), Follow-Up Studies, Heart Failure, Humans, Hypertension, Kidney Diseases, Middle Aged, Obesity, Risk Factors, Cohort Studies, Comorbidity, Proportional Hazards Models, Randomized Controlled Trials as Topic, Medroxyprogesterone Acetate, Hypertrophy, Left Ventricular, Postmenopause, Hormone Replacement Therapy

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