Original investigation
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:10.1186/1475-2840-10-15
Published: 8 February 2011Abstract
Background
To assess heart failure therapies in diabetic patients with preserved as compared to impaired systolic ventricular function.
Methods
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.
Results
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.
Conclusions
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.
