PMID- 35322592 OWN - NLM STAT- MEDLINE DCOM- 20220505 LR - 20240320 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 9 IP - 3 DP - 2022 Jun TI - Cardiovascular outcomes associated with treatment of type 2 diabetes in patients with ischaemic heart failure. PG - 1608-1615 LID - 10.1002/ehf2.13910 [doi] AB - AIM: The optimal strategy for diabetes control in patients with heart failure (HF) following myocardial infarction (MI) remains unknown. Metformin, a guideline-recommended therapy for patients with chronic HF and type 2 diabetes mellitus (T2DM), is associated with reduced mortality and HF hospitalizations. However, worse outcomes have been reported when used at the time of MI. We compared outcomes of patients with T2DM and HF of ischaemic aetiology according to antidiabetic treatment. METHODS AND RESULTS: This study used linked data from primary care, hospital admissions, and death registries for 4.7 million inhabitants in England, as part of the CALIBER resource. The primary endpoint was a composite of cardiovascular mortality and HF hospitalization. The secondary endpoints were the individual components of the primary endpoint and all-cause mortality. To evaluate the effect of temporal changes in diabetes treatment, antidiabetic medication was included as time-dependent covariates in survival analyses. The study included 1172 patients with T2DM and prior MI and incident HF between 3 January 1998 and 26 February 2010. Five hundred and ninety-six patients had the primary outcome over median follow-up of 2.53 (IQR: 0.98-4.92) years. Adjusted analyses showed a reduced hazard of the composite endpoint for exposure to all antidiabetic medication with hazard ratios (HRs) of 0.50 [95% confidence interval (CI): 0.42-0.59], 0.66 (95% CI: 0.55-0.80), and 0.53 (95% CI: 0.43-0.65), respectively. A similar effect was seen for all-cause mortality [HRs of 0.43 (95% CI: 0.35-0.52), 0.57 (95% CI: 0.46-0.70), and 0.34 (95% CI: 0.27-0.43), respectively]. CONCLUSIONS: When considering changes in antidiabetic treatment over time, all drug classes were associated with reduced risk of cardiovascular mortality and HF hospitalization. CI - (c) 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Godec, Thomas R AU - Godec TR AD - Department of Medical Statistics, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London, UK. FAU - Bromage, Daniel I AU - Bromage DI AUID- ORCID: 0000-0002-4243-5964 AD - School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, James Black Centre, 125 Coldharbour Lane, London, SE5 9NU, UK. FAU - Pujades-Rodriguez, Mar AU - Pujades-Rodriguez M AD - Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. FAU - Cannata, Antonio AU - Cannata A AD - School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, James Black Centre, 125 Coldharbour Lane, London, SE5 9NU, UK. FAU - Gonzalez-Izquierdo, Arturo AU - Gonzalez-Izquierdo A AD - Institute of Health Informatics, University College London, London, UK. AD - Health Data Research UK London, University College London, London, UK. AD - The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London, London, UK. FAU - Denaxas, Spiros AU - Denaxas S AD - Institute of Health Informatics, University College London, London, UK. AD - Health Data Research UK London, University College London, London, UK. AD - The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London, London, UK. FAU - Hemingway, Harry AU - Hemingway H AD - Institute of Health Informatics, University College London, London, UK. AD - Health Data Research UK London, University College London, London, UK. AD - The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London, London, UK. FAU - Shah, Ajay M AU - Shah AM AD - School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, James Black Centre, 125 Coldharbour Lane, London, SE5 9NU, UK. FAU - Yellon, Derek M AU - Yellon DM AD - The Hatter Cardiovascular Institute, University College London, London, UK. FAU - McDonagh, Theresa A AU - McDonagh TA AD - School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, James Black Centre, 125 Coldharbour Lane, London, SE5 9NU, UK. LA - eng GR - RP-PG-0407-10314/DH_/Department of Health/United Kingdom GR - 086091/Z/08/Z/WT_/Wellcome Trust/United Kingdom GR - BHF_/British Heart Foundation/United Kingdom GR - MC_PC_20059/MRC_/Medical Research Council/United Kingdom GR - MR/K006584/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220323 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 RN - 0 (Hypoglycemic Agents) RN - 9100L32L2N (Metformin) SB - IM MH - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology MH - *Heart Failure/complications/epidemiology/therapy MH - Hospitalization MH - Humans MH - Hypoglycemic Agents/therapeutic use MH - *Metformin/adverse effects MH - *Myocardial Infarction/complications PMC - PMC9065866 OTO - NOTNLM OT - Antidiabetic agents OT - Heart failure OT - Ischaemic cardiomyopathy OT - Metformin OT - Outcomes OT - Type 2 diabetes COIS- None declared. EDAT- 2022/03/25 06:00 MHDA- 2022/05/06 06:00 PMCR- 2022/03/23 CRDT- 2022/03/24 05:42 PHST- 2022/01/31 00:00 [revised] PHST- 2021/11/20 00:00 [received] PHST- 2022/03/11 00:00 [accepted] PHST- 2022/03/25 06:00 [pubmed] PHST- 2022/05/06 06:00 [medline] PHST- 2022/03/24 05:42 [entrez] PHST- 2022/03/23 00:00 [pmc-release] AID - EHF213910 [pii] AID - 10.1002/ehf2.13910 [doi] PST - ppublish SO - ESC Heart Fail. 2022 Jun;9(3):1608-1615. doi: 10.1002/ehf2.13910. Epub 2022 Mar 23.