Related Experiment Video
Updated: Jun 16, 2025
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Heart Failure Risk Prediction in a Population With a High Burden of Diabetes: Evidence From the Strong Heart Study
Irene Martinez-Morata1, Arce Domingo-Relloso1,2, Ying Zhang3
1Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY USA.
Insights
Heart failure risk in American Indians is high. This study identified smoking, diabetes control (glycated hemoglobin), and kidney damage (albuminuria) as key predictors, improving risk assessment for this population.
Area of Science:
- Cardiovascular epidemiology
- Diabetes research
- American Indian health
Background:
- High burden of diabetes and cardiovascular risk factors in American Indian communities.
- Scarcity of prospective heart failure (HF) studies in this population.
- Limited generalizability of existing HF risk scales.
Purpose of the Study:
- Develop a parsimonious HF risk prediction equation for American Indians.
- Identify key risk factors for HF in this population, focusing on diabetes and kidney damage.
Main Methods:
- Prospective study of 3059 participants from the Strong Heart Study (SHS).
- Utilized Cox proportional hazards models to identify HF risk factors.
- Follow-up up to 28 years.
Main Results:
- Older age, smoking, macroalbuminuria, microalbuminuria, and previous myocardial infarction were significant HF predictors.
- Diabetes diagnosis, glycated hemoglobin, and albuminuria were significant predictors at 10 and 28 years.
- Achieved high discrimination performance (C-index 0.77-0.81).
Conclusions:
- Smoking, body mass index, glycated hemoglobin, and albuminuria are major determinants of HF in American Indian communities.
- Findings can improve HF risk assessment in populations with high diabetes burden.
- Diabetes, albuminuria, and myocardial infarction were associated with all HF subtypes.
Background:
Despite the high burden of diabetes and cardiovascular risk factors in American Indian communities in the United States, prospective studies of heart failure (HF) in this population group are scarce, and the generalizability of previous HF risk scales may be limited. We developed a parsimonious HF risk prediction equation that accounts for relevant risk factors affecting American Indian communities, focusing on diabetes and kidney damage.
Methods And Results:
A total of 3059 participants from the SHS (Strong Heart Study) (56±8 years of age, 58% women) were included. Five hundred seven developed HF. Progressively adjusted Cox proportional hazards models were used to identify risk factors for HF and HF subtypes. Predictors of risk at 5 and 10 years included older age (hazard ratio [HR], 1.79 [95% CI, 1.43-2.25]; HR, 1.68 [95% CI, 1.44-1.95]), smoking (HR, 2.26 [95% CI, 1.23-4.13]; HR, 2.08 [95% CI, 1.41-3.06]), macroalbuminuria (HR, 8.38 [95% CI, 4.44-15.83]; HR, 5.20 [95% CI, 3.42-7.9]), microalbuminuria (HR, 2.72 [95% CI, 1.51-4.90]; HR, 1.92 [95% CI, 1.33, 2.78]), and previous myocardial infarction (HR, 6.58 [95% CI, 2.54-17.03]; HR, 3.87 [95% CI, 2.29-6.54]), respectively. These predictors, together with diabetes diagnosis and glycated hemoglobin were significant at 10 and 28 years. High discrimination performance was achieved (C index, 0.81 [95% CI, 0.76-0.84]; C index, 0.78 [95% CI, 0.75-0.81]; and C index, 0.77 [95% CI, 0.74-0.78] at 5, 10, and up to 28 years of follow up, respectively). Some associations varied across HF subtypes, although diabetes, albuminuria, and previous myocardial infarction were associated with all subtypes.
Conclusions:
This prospective study of HF risk factors in American Indian communities identifies that smoking, body mass index, and indicators of diabetes control and kidney damage (glycated hemoglobin and albuminuria) are major determinants of HF. Our findings can improve HF risk assessment in populations with a high burden of diabetes.
More Related Videos
07:49Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
Published on: July 21, 2023
07:22Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
Published on: March 7, 2025
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:22Heart Failure Drugs: Diuretics
01:22Heart Failure Drugs: β-Blockers
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Symptoms, Diagnosis, and Complications