PMID- 29960591
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20221207
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 17
IP  - 1
DP  - 2018 Jun 30
TI  - Prognostic impact of HbA1c variability on long-term outcomes in patients with 
      heart failure and type 2 diabetes mellitus.
PG  - 96
LID - 10.1186/s12933-018-0739-3 [doi]
LID - 96
AB  - BACKGROUND: The prognostic impact of long-term glycemic variability on clinical 
      outcomes in patients with heart failure (HF) and type 2 diabetes mellitus (T2DM) 
      remains unclear. We determined and compared hemoglobin A1c (HbA1c) variability 
      and clinical outcomes for patients with HF with preserved ejection fraction 
      (HFpEF), HF with mid-range ejection fraction (HFmrEF) and HF with reduced 
      ejection fraction (HFrEF) in a prospective longitudinal study. METHODS: Patients 
      with HF and T2DM, undergone 3 or more HbA1c determinations during the first 
      18 months, were then followed for 42 months. The primary outcome was death from 
      any cause. Secondary outcome was composite endpoints with death and HF 
      hospitalization. Cox proportional hazards models were used to compare outcomes 
      for patients with HFpEF, HFmrEF and HFrEF. RESULTS: Of 902 patients enrolled, 
      32.2% had HFpEF, 14.5% HFmrEF, and 53.3% HFrEF. During 42 months of follow-up, 
      270 (29.9%) patients died and 545 (60.4%) patients experienced composite 
      endpoints of death and HF readmission. The risk of all-cause death or composite 
      endpoints was lower for HFpEF than HFrEF. Moreover, higher HbA1c variability was 
      associated with higher all-cause mortality or composite endpoints and HbA1c 
      variability was an independent predictor of all-cause mortality or composite 
      endpoints, regardless of EF. CONCLUSIONS: This prospective longitudinal study 
      showed that the all-cause death and composite events was lower for HFpEF than 
      HFrEF. HbA1c variability was independently and similarly predictive of death or 
      combined endpoints in the three HF phenotypes.
FAU - Gu, Jun
AU  - Gu J
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China.
FAU - Pan, Jian-An
AU  - Pan JA
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China.
FAU - Fan, Yu-Qi
AU  - Fan YQ
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China.
FAU - Zhang, Hui-Li
AU  - Zhang HL
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China.
FAU - Zhang, Jun-Feng
AU  - Zhang JF
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China.
FAU - Wang, Chang-Qian
AU  - Wang CQ
AUID- ORCID: 0000-0002-3581-5117
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, People's 
      Republic of China. shxkliuxu@126.com.
LA  - eng
GR  - 81670293/National Nature Science Foundation of China/International
GR  - 18411950500/Science and Technology Commission of Shanghai 
      Municipality/International
GR  - 16CR2034B/Shanghai Shenkang hospital development center/International
GR  - JYLJ017/Clinical Research Program of 9th People's Hospital affiliated to Shanghai 
      JiaoTong university School of Medicine/International
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20180630
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Biomarkers)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Diabetes Mellitus, Type 2/*blood/diagnosis/mortality/therapy
MH  - Female
MH  - Glycated Hemoglobin/*metabolism
MH  - Heart Failure/diagnosis/mortality/*physiopathology/therapy
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke Volume
MH  - Time Factors
MH  - Ventricular Function, Left
PMC - PMC6026342
OTO - NOTNLM
OT  - Heart failure
OT  - Hemoglobin A1c variability
OT  - Hospitalization
OT  - Mortality
OT  - Type 2 diabetes mellitus
EDAT- 2018/07/02 06:00
MHDA- 2019/01/29 06:00
PMCR- 2018/06/30
CRDT- 2018/07/02 06:00
PHST- 2018/05/04 00:00 [received]
PHST- 2018/06/26 00:00 [accepted]
PHST- 2018/07/02 06:00 [entrez]
PHST- 2018/07/02 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2018/06/30 00:00 [pmc-release]
AID - 10.1186/s12933-018-0739-3 [pii]
AID - 739 [pii]
AID - 10.1186/s12933-018-0739-3 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2018 Jun 30;17(1):96. doi: 10.1186/s12933-018-0739-3.