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Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial.

Publication ,  Journal Article
Sarma, S; Mentz, RJ; Kwasny, MJ; Fought, AJ; Huffman, M; Subacius, H; Nodari, S; Konstam, M; Swedberg, K; Maggioni, AP; Zannad, F; Bonow, RO ...
Published in: Eur J Heart Fail
February 2013

AIMS: We evaluated the impact of diabetes mellitus (DM) and diabetic therapy on outcomes in patients with reduced ejection fraction (EF) after hospitalization for heart failure (HF). DM is prevalent in patients hospitalized with HF, yet inconclusive data exist on the post-discharge outcomes of this patient population. METHODS AND RESULTS: Post-hoc analysis was performed on the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan) study, a randomized trial of patients hospitalized with HF (n = 4133) with median follow-up of 9.9 months. DM status was determined from intake questionnaires and cross-verified by medication history. Univariate relationships were examined using χ(2) test, t-test, and Wilcoxon tests. The two primary outcomes of (i) all-cause mortality (ACM) and (ii) cardiovascular mortality or HF hospitalization (CVM + HFH) were assessed for those with and without DM and by diabetic treatment strategy using log rank tests and multivariable Cox regression models. DM was present in 40% of participants. Patients with DM were more likely to have hypertension, coronary artery disease, and chronic kidney disease. Diabetes was associated with ACM and CVM + HFH (both P < 0.001). Following multivariate risk adjustment, DM was associated with ACM, but this estimate was imprecise [hazard ratio (HR) 1.16; 95% confidence interval (CI) 1.00-1.34] and remained associated with CVM or HFH (HR 1.17; 95% CI 1.04-1.31). Diabetic control strategy did not independently affect outcomes. CONCLUSION: Diabetes is common in patients hospitalized for heart failure with a reduced EF. These patients have a higher post-discharge CVM and higher HF hospitalizations compared with patients with no diabetes. Different diabetic treatment regimens did not appear to influence post-discharge outcomes.

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Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

February 2013

Volume

15

Issue

2

Start / End Page

194 / 202

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tolvaptan
  • Proportional Hazards Models
  • Patient Discharge
  • Middle Aged
  • Male
  • Insulin
  • Hypoglycemic Agents
  • Humans
  • Hospitalization
 

Citation

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Sarma, S., Mentz, R. J., Kwasny, M. J., Fought, A. J., Huffman, M., Subacius, H., … EVEREST investigators, . (2013). Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial. Eur J Heart Fail, 15(2), 194–202. https://doi.org/10.1093/eurjhf/hfs153
Sarma, Satyam, Robert J. Mentz, Mary J. Kwasny, Angela J. Fought, Mark Huffman, Haris Subacius, Savina Nodari, et al. “Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial.Eur J Heart Fail 15, no. 2 (February 2013): 194–202. https://doi.org/10.1093/eurjhf/hfs153.
Sarma S, Mentz RJ, Kwasny MJ, Fought AJ, Huffman M, Subacius H, et al. Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial. Eur J Heart Fail. 2013 Feb;15(2):194–202.
Sarma, Satyam, et al. “Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial.Eur J Heart Fail, vol. 15, no. 2, Feb. 2013, pp. 194–202. Pubmed, doi:10.1093/eurjhf/hfs153.
Sarma S, Mentz RJ, Kwasny MJ, Fought AJ, Huffman M, Subacius H, Nodari S, Konstam M, Swedberg K, Maggioni AP, Zannad F, Bonow RO, Gheorghiade M, EVEREST investigators. Association between diabetes mellitus and post-discharge outcomes in patients hospitalized with heart failure: findings from the EVEREST trial. Eur J Heart Fail. 2013 Feb;15(2):194–202.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

February 2013

Volume

15

Issue

2

Start / End Page

194 / 202

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tolvaptan
  • Proportional Hazards Models
  • Patient Discharge
  • Middle Aged
  • Male
  • Insulin
  • Hypoglycemic Agents
  • Humans
  • Hospitalization