How Does Diabetes Influence Heart Failure?

Diabetes appears to play a critical role in the progression from preclinical heart failure (HF) to overt HF, according to a poster presented at the 83rd Scientific Sessions of the American Diabetes Association in San Diego, California.

In this analysis, Dr. Justin B. Echouffo Tcheugi, and colleagues assessed 4264 adults (mean age, 76 years; 62% women; 24% Black) with preclinical HF (stage A [n=1174] or B [n=3090]) who attended the Atherosclerosis Risk in Communities Study Visit 5 (2011-2013). Stage A preclinical HF was defined by HF risk factors only. Stage B1 HF was defined as echocardiographic abnormalities but no biomarker elevation; Stage B2 HF was defined as elevated NT-pro-BNP ≥125 pg/mL and/or hscTnT>14 ng/L but no echocardiographic abnormality; and Stage B3 HF was defined as the presence of echocardiographic and biomarker abnormalities. Researchers assessed the association between diabetes and each preclinical Stage B phenotype with incident HF and HF or death.

The researchers observed 383 HF events and 730 deaths over the 8.6 years of follow-up. Their findings linked diabetes with a high absolute risk of HF across all preclinical B stages of HF, but the association was especially strong for the Stage B3 phenotype. Overall, the study showed that individuals with diabetes and Stage B3 HF had the highest risk of HF or HF and death combined. “Addressing diabetes appears to be critical in Stage B individuals with both echocardiographic and biomarkers abnormalities for preventing the progression to HF,” the researchers concluded.