Long-term outcome in diabetic heart failure patients treated with cardiac resynchronization therapy

Cecilia Fantoni, François Regoli, Ali Ghanem, Santi Raffa, Catherine Klersy, Antonio Sorgente, Francesco Faletra, Massimo Baravelli, Luigi Inglese, Jorge A. Salerno-Uriarte, Helmut U. Klein, Tiziano Moccetti, Angelo Auricchio

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Diabetes mellitus is an independent risk factor for increased morbidity and mortality in heart failure (HF) patients. Aims: To compare functional and structural improvement, as well as long-term outcome, between diabetic and non-diabetic HF patients treated with cardiac resynchronization therapy (CRT). Methods: We compared response to CRT in 141 diabetic and 214 non-diabetic consecutive patients. Major events were; death from any cause, urgent heart transplantation and implantation of a left ventricular (LV) assist device. Frequencies of hospitalisation and defibrillator (CRT-D) discharges were also analyzed. Results: CRT was able to significantly improve functional capacity, ventricular geometry and neurohumoral imbalance in both diabetic and non-diabetic patients over a median follow-up time of 34 months. Overall event-free survival was similar in diabetic and non-diabetic patients (HR 1.23, p = 0.363), as was survival free from CRT-D interventions (HR 1.72; p = 0.115) and hospitalisations (HR 1.12; p = 0.500). On multivariable analysis, NYHA class IV (p = 0.002), low LV ejection fraction (p = 0.002), absence of beta-blocker therapy (p <0.001), impaired renal function (p = 0.003), presence of an epicardial lead (p = 0.025), but not diabetes (p = 0.821) were associated with a poor outcome after CRT. Conclusions: Diabetic HF patients treated with CRT had a very favourable functional and survival outcome, which was comparable to non-diabetic patients.

Original languageEnglish
Pages (from-to)298-307
Number of pages10
JournalEuropean Journal of Heart Failure
Volume10
Issue number3
DOIs
Publication statusPublished - Mar 2008

Keywords

  • Cardiac resynchronization therapy
  • Diabetes mellitus
  • Heart failure
  • Outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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