Effect of cardiac resynchronization on morbidity and mortality of diabetic patients with severe heart failure
Abstract
Diabetes is a well-known and important risk factor for heart disease, including heart failure (1–4). Despite improvements in pharmacologic treatment, many patients with heart failure have severe and persistent symptoms, and their prognosis remains poor (5,6). While most recent data indicate a higher mortality rate in diabetic patients with heart failure compared with nondiabetic patients (7–9), it is unresolved whether this effect might be limited to patients with ischemic heart disease and/or patients on insulin therapy (10–13). Cardiac resynchronization therapy (CRT) reduces symptoms and improves left ventricular function and prognosis in many patients with moderate-to-severe heart failure due to systolic dysfunction and cardiac dyssynchrony (14–19). The pathophysiology underlying heart failure in diabetic patients differs from that in nondiabetic patients and is generally considered more progressive. Thus, direct and indirect effects of diabetes on myopathic mechanisms might influence the response of heart failure patients to CRT. We conducted an analysis of the 813 participants of the Cardiac Resynchronisation in Heart Failure (CARE-HF) trial to determine the effect of CRT on the risk of complications and death in diabetic compared with nondiabetic heart failure patients. We also tested the hypothesis that diabetes has a prognostic impact in patients with heart failure. The CARE-HF trial (14,20–22) investigated the effects of cardiac resynchronization on morbidity and mortality in patients receiving standard pharmacologic therapy …
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Both COMPANION and CARE-HF demonstrated similar effectiveness of CRT for the reduction in mortality and HF hospitalization in relation to T2DM status.
“In relation to T2DM status, both COMPANION (41%o fT 2 D M patients), and CARE-HF (29% of T2DM patients) demonstrated similar effectiveness of CRT for the reduction in mortality and HF hospitalization.171,172”
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 [172]
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- Authors
- Hoppe, U. C., Freemantle, N., Cleland, J. G. F., Marijianowski, M., & Erdmann, E.
- Affiliations
- University of Cologne (DE)
- University of Birmingham (GB)
- Castle Hill Hospital (GB)
- Medtronic (Netherlands) (NL)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2007-03-01
- Volume
- 30
- Issue
- 3
- Pages
- 722-724
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2098198487
- Cited by
- 43
- References
- 31
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 2 · 2013: 1 · 2012: 4
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Keywords
- cardiac resynchronization therapy, diabetic heart failure, diabetes mellitus, heart failure prognosis, mortality, morbidity, insulin therapy, ischemic heart disease, CARE-HF trial, cardiac dyssynchrony, left ventricular function
- MeSH terms
- Cardiac Pacing, Artificial, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Heart Failure, Humans, Prognosis, Survival Analysis, Treatment Outcome, Myocardial Ischemia, Ventricular Dysfunction, Left
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