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Diabetes and treatment of chronic heart failure in a large real‐world heart failure population

AIMS: Although diabetes mellitus (DM) is a common co‐morbidity in chronic heart failure (HF) patients, European data on concurrent HF and DM treatment are lacking. Therefore, we have studied the HF treatment of patients with and without DM. Additionally, with the recent breakthrough of sodium–glucos...

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Autores principales: Radhoe, Sumant P., Veenis, Jesse F., Linssen, Gerard C.M., van der Lee, Chris, Eurlings, Luc W.M., Kragten, Hans, Al‐Windy, Nadea Y.Y., van der Spank, Aukje, Koudstaal, Stefan, Brunner‐La Rocca, Hans‐Peter, Brugts, Jasper J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788034/
https://www.ncbi.nlm.nih.gov/pubmed/34862765
http://dx.doi.org/10.1002/ehf2.13743
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author Radhoe, Sumant P.
Veenis, Jesse F.
Linssen, Gerard C.M.
van der Lee, Chris
Eurlings, Luc W.M.
Kragten, Hans
Al‐Windy, Nadea Y.Y.
van der Spank, Aukje
Koudstaal, Stefan
Brunner‐La Rocca, Hans‐Peter
Brugts, Jasper J.
author_facet Radhoe, Sumant P.
Veenis, Jesse F.
Linssen, Gerard C.M.
van der Lee, Chris
Eurlings, Luc W.M.
Kragten, Hans
Al‐Windy, Nadea Y.Y.
van der Spank, Aukje
Koudstaal, Stefan
Brunner‐La Rocca, Hans‐Peter
Brugts, Jasper J.
author_sort Radhoe, Sumant P.
collection PubMed
description AIMS: Although diabetes mellitus (DM) is a common co‐morbidity in chronic heart failure (HF) patients, European data on concurrent HF and DM treatment are lacking. Therefore, we have studied the HF treatment of patients with and without DM. Additionally, with the recent breakthrough of sodium–glucose cotransporter 2 (SGLT2) inhibitors in the field of HF, we studied the potential impact of this new drug in a large cohort of HF patients. METHODS AND RESULTS: A total of 7488 patients with chronic HF with a left ventricular ejection fraction <50% from 34 Dutch outpatient HF clinics between 2013 and 2016 were analysed on diabetic status and background HF therapy. Average age of the total population was 72.8 years (±11.7 years), and 64% of the patients were male. Diabetes was present in 29% of the patients (N = 2174). Diabetics had a worse renal function (mean estimated glomerular filtration rate 56 vs. 61 mL/min/1.73 m(2), P < 0.001). Renin–angiotensin system inhibitors were less often prescribed in diabetics compared with non‐diabetics (79% vs. 82%, P = 0.001), while no significant differences regarding other guideline‐recommended HF drugs were found. Target doses of beta‐blockers (23% vs. 16%, P < 0.001), renin–angiotensin system inhibitors (47% vs. 43%, P = 0.009), and mineralocorticoid receptor antagonists (57% vs. 51%, P = 0.005) were more often prescribed in diabetics than non‐diabetics. Based on the latest trials on SGLT2 inhibitors, 31–64% of all HF patients would fulfil the eligibility or enrichment criteria (with vs. without N‐terminal prohormone BNP criterion). CONCLUSIONS: In this large real‐world HF registry, a high prevalence of DM was observed and diabetics more often received guideline‐recommended target doses. Based on current evidence, the majority of patients would fulfil the enrichment criteria of SGLT2 trials in HF and the impact of this new drug class will be large.
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spelling pubmed-87880342022-01-31 Diabetes and treatment of chronic heart failure in a large real‐world heart failure population Radhoe, Sumant P. Veenis, Jesse F. Linssen, Gerard C.M. van der Lee, Chris Eurlings, Luc W.M. Kragten, Hans Al‐Windy, Nadea Y.Y. van der Spank, Aukje Koudstaal, Stefan Brunner‐La Rocca, Hans‐Peter Brugts, Jasper J. ESC Heart Fail Original Articles AIMS: Although diabetes mellitus (DM) is a common co‐morbidity in chronic heart failure (HF) patients, European data on concurrent HF and DM treatment are lacking. Therefore, we have studied the HF treatment of patients with and without DM. Additionally, with the recent breakthrough of sodium–glucose cotransporter 2 (SGLT2) inhibitors in the field of HF, we studied the potential impact of this new drug in a large cohort of HF patients. METHODS AND RESULTS: A total of 7488 patients with chronic HF with a left ventricular ejection fraction <50% from 34 Dutch outpatient HF clinics between 2013 and 2016 were analysed on diabetic status and background HF therapy. Average age of the total population was 72.8 years (±11.7 years), and 64% of the patients were male. Diabetes was present in 29% of the patients (N = 2174). Diabetics had a worse renal function (mean estimated glomerular filtration rate 56 vs. 61 mL/min/1.73 m(2), P < 0.001). Renin–angiotensin system inhibitors were less often prescribed in diabetics compared with non‐diabetics (79% vs. 82%, P = 0.001), while no significant differences regarding other guideline‐recommended HF drugs were found. Target doses of beta‐blockers (23% vs. 16%, P < 0.001), renin–angiotensin system inhibitors (47% vs. 43%, P = 0.009), and mineralocorticoid receptor antagonists (57% vs. 51%, P = 0.005) were more often prescribed in diabetics than non‐diabetics. Based on the latest trials on SGLT2 inhibitors, 31–64% of all HF patients would fulfil the eligibility or enrichment criteria (with vs. without N‐terminal prohormone BNP criterion). CONCLUSIONS: In this large real‐world HF registry, a high prevalence of DM was observed and diabetics more often received guideline‐recommended target doses. Based on current evidence, the majority of patients would fulfil the enrichment criteria of SGLT2 trials in HF and the impact of this new drug class will be large. John Wiley and Sons Inc. 2021-12-04 /pmc/articles/PMC8788034/ /pubmed/34862765 http://dx.doi.org/10.1002/ehf2.13743 Text en © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Radhoe, Sumant P.
Veenis, Jesse F.
Linssen, Gerard C.M.
van der Lee, Chris
Eurlings, Luc W.M.
Kragten, Hans
Al‐Windy, Nadea Y.Y.
van der Spank, Aukje
Koudstaal, Stefan
Brunner‐La Rocca, Hans‐Peter
Brugts, Jasper J.
Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title_full Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title_fullStr Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title_full_unstemmed Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title_short Diabetes and treatment of chronic heart failure in a large real‐world heart failure population
title_sort diabetes and treatment of chronic heart failure in a large real‐world heart failure population
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788034/
https://www.ncbi.nlm.nih.gov/pubmed/34862765
http://dx.doi.org/10.1002/ehf2.13743
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