Prevalence and Prognostic Implications of Pre-Diabetic State in Patients With Heart Failure

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概要

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• Background: Diabetes mellitus (DM) is a risk factor of poor prognosis in patients with heart failure (HF). The prevalence and prognostic impact of the pre-diabetic state, however, are not well understood. Methods and Results: One hundred and thirty-six consecutive patients admitted due to HF were included in this prospective study. The 75-g oral glucose tolerance test (OGTT) was performed in all patients without known DM, and patients were classified into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and DM groups. Forty-two of the 136 patients had previously been diagnosed with diabetes. Of the remaining 94 patients without known diabetes, 35 (37.2%) patients were classified as NGT, 9 (9.6%) as having IFG, 37 (39.4%) were classified as having IGT, and 13 (13.8%) were newly diagnosed with DM. During follow-up, patients with DM or IGT had significantly lower major adverse cardiac and cerebrovascular event (MACCE)-free rates than NGT patients (P=0.006, P=0.036, respectively). IFG, however, was not significantly related to increased MACCE risk. The presence of IGT (hazard ratio [HR], 4.51; P=0.011) and DM (HR, 4.74; P=0.005) were independent predictors of MACCE even after multivariate analysis. Conclusions: IGT and DM contribute to adverse prognosis in patients with HF. It is feasible to perform diabetes screening using OGTT in patients with HF for risk stratification. (Circ J 2011; 75: 2833-2839)

• 社団法人　日本循環器学会の論文
• 2011-11-25

著者

• Matsumura Akihiko

  Department of Cardiology, Kameda Medical Center

• Ohno Masakazu

  Department of Cardiology, Kameda Medical Center

• Matue Yuya

  Department Of Cardiology Kameda Medical Center

• Iwatsuka Ryota

  Department Of Cardiology Kameda Medical Center

• Mizukami Akira

  Department Of Cardiology Kameda Medical Center

• Nagahori Wataru

  Department Of Cardiology Kameda Medical Center

• Matsumura Akihiko

  Department Of Cardiology Kameda Medical Center

• Yoshikawa Shunji

  Department Of Cardiology Social Insurance Central General Hospital

• Oono Masakazu

  Kameda Medical Center

• Suzuki Makoto

  Division Of Cardiology Department Of Integrated Medicine And Informatics Ehime University Graduate S

• Iwatsuka Ryota

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• MATSUE Yuya

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• NAKAMURA Rena

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• ABE Masami

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• ONO Maki

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• YOSHIDA Seigo

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• SEYA Mie

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• MIZUKAMI Akira

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• SETOGUCHI Masahiko

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• NAGAHORI Wataru

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• OHNO Masakazu

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• MATSUMURA Akihiko

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• HASHIMOTO Yuji

  Division of Cardiology, Department of Medicine, Kameda Medical Center

• Seya Mie

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Nakamura Rena

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Mizukami Akira

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Nagahori Wataru

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Setoguchi Masahiko

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Yoshida Seigo

  Division Of Cardiology Department Of Medicine Kameda Medical Center

• Abe Masami

  Division Of Cardiology Department Of Medicine Kameda Medical Center

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