Heart failure therapy in diabetic patients-comparison with the recent ESC/EASD guideline
- Equal contributors
1 Department of Cardiology and Pneumology, University of Göttingen, Göttingen, Germany
2 Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany
3 Medical Clinic and Policlinic I, University of Würzburg, Würzburg, Germany
4 Clinic for Internal Medicine and Cardiology, University of Marburg, Marburg, Germany
5 Department of Cardiology, University Duisburg-Essen, Germany
6 Clinical Trial Center, University of Leipzig, Leipzig, Germany
7 Department of Cardiology, Medical University of Graz, Graz, Austria
Cardiovascular Diabetology 2011, 10:15 doi:10.1186/1475-2840-10-15Published: 8 February 2011
To assess heart failure therapies in diabetic patients with preserved as compared to impaired systolic ventricular function.
3304 patients with heart failure from 9 different studies were included (mean age 63 ± 14 years); out of these, 711 subjects had preserved left ventricular ejection fraction (≥ 50%) and 994 patients in the whole cohort suffered from diabetes.
The majority (>90%) of heart failure patients with reduced ejection fraction (SHF) and diabetes were treated with an ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) or with beta-blockers. By contrast, patients with diabetes and preserved ejection fraction (HFNEF) were less likely to receive these substance classes (p < 0.001) and had a worse blood pressure control (p < 0.001). In comparison to patients without diabetes, the probability to receive these therapies was increased in diabetic HFNEF patients (p < 0.001), but not in diabetic SHF patients. Aldosterone receptor blockers were given more often to diabetic patients with reduced ejection fraction (p < 0.001), and the presence and severity of diabetes decreased the probability to receive this substance class, irrespective of renal function.
Diabetic patients with HFNEF received less heart failure medication and showed a poorer control of blood pressure as compared to diabetic patients with SHF. SHF patients with diabetes were less likely to receive aldosterone receptor blocker therapy, irrespective of renal function.