Prevalence and prognostic implications of pre-diabetic state in patients with heart failure

Yuya Matsue1, Makoto Suzuki, Rena Nakamura

  • 1Department of Medicine, Kameda Medical Center, Chiba, Japan. yuyam@kameda.jp

Insights

Pre-diabetic states like impaired glucose tolerance (IGT) and diabetes mellitus (DM) worsen outcomes for heart failure (HF) patients. Screening for these conditions using oral glucose tolerance tests (OGTT) can help identify high-risk individuals.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Diabetes mellitus (DM) is a known risk factor for poor prognosis in heart failure (HF) patients.
  • The prognostic impact and prevalence of pre-diabetic states in HF are not well understood.

Purpose of the Study:

  • To investigate the prevalence and prognostic significance of glucose metabolism abnormalities, including pre-diabetes, in patients with heart failure.
  • To assess the association between different glucose tolerance categories and major adverse cardiac and cerebrovascular events (MACCE) in HF patients.

Main Methods:

  • A prospective study included 136 consecutive HF patients without previously diagnosed DM.
  • The 75-g oral glucose tolerance test (OGTT) classified patients into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and newly diagnosed DM groups.
  • Major adverse cardiac and cerebrovascular events (MACCE) were monitored during follow-up.

Main Results:

  • Of 94 patients without known DM, 37.2% had NGT, 9.6% had IFG, 39.4% had IGT, and 13.8% were newly diagnosed with DM.
  • Patients with DM or IGT showed significantly lower MACCE-free rates compared to NGT patients (P=0.006 and P=0.036, respectively).
  • IFG was not significantly associated with increased MACCE risk, but IGT (HR, 4.51; P=0.011) and DM (HR, 4.74; P=0.005) were independent predictors of MACCE.

Conclusions:

  • Impaired glucose tolerance (IGT) and diabetes mellitus (DM) significantly contribute to an adverse prognosis in heart failure patients.
  • Diabetes screening via OGTT is feasible and valuable for risk stratification in HF patients.
Abstract

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