Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes...

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Syndrome

Background:

• Insulin resistance (HOMA-R) is linked to myocardial damage in healthy individuals.
• Diabetes mellitus (DM) worsens prognosis in heart failure (HF) patients.
• The role of pancreatic beta-cell dysfunction in HF without DM is unclear.

Purpose of the Study:

• To investigate the impact of pancreatic beta-cell dysfunction on clinical outcomes in heart failure patients without diabetes mellitus.
• To compare the prognostic value of beta-cell dysfunction versus insulin resistance in this population.

Main Methods:

• 312 heart failure patients without DM were enrolled.
• Pancreatic beta-cell dysfunction was defined as HOMA-beta <30%.
• Cardiovascular events were tracked, and analyses included Kaplan-Meier and Cox hazard models.

Main Results:

• 35% of patients (108) exhibited pancreatic beta-cell dysfunction.
• Patients with beta-cell dysfunction had higher plasma brain natriuretic peptide levels (625.2 vs. 399.0 pg/mL, P<0.001).
• Beta-cell dysfunction was associated with significantly higher cardiovascular event rates (log-rank test, P=0.001) and independently predicted adverse outcomes (HR, 1.58; 95% CI: 1.02-2.45).
• Insulin resistance did not show a significant association with cardiovascular events.

Conclusions:

• Pancreatic beta-cell dysfunction is an independent predictor of unfavorable outcomes in heart failure patients without diabetes mellitus.
• Insulin resistance was not associated with adverse cardiovascular events in this cohort.
• These findings suggest targeting beta-cell function may be important for managing heart failure outcomes in non-diabetic patients.