JACC:高血糖大大推进亚临床心衰的进展!

2022-06-15 MedSci原创 MedSci原创

在亚临床心衰的老年人中,控制不佳的糖尿病与心衰进展的高风险密切相关

在全球范围内,糖尿病和心力衰竭(HF)都非常普遍,而且这两种疾病之间存在很强的相关性。基本上,每3个心衰患者中就有1个合并糖尿病,此外,糖尿病使心衰风险升高了2-5倍。但是,糖尿病对从亚临床心衰阶段进展成显性心衰的影响尚不明确。

该研究目的是归纳糖尿病对亚临床心衰(A期或B期)至显性心衰进展过程的影响。

纳入了参与ARIC研究(2011-2013)的4774位亚临床心衰(A期:1551人,B期:3223人)。研究人员在各期(A期或B期)受试者中分别评估了糖尿病和血糖控制(糖化血红蛋白[HbA1c]<7% vs ≥7%)与心衰进展的相关性,以及心衰分期的跨类别(A vs B)、糖尿病和血糖控制与心衰事件的关系。


糖尿病和亚临床心衰与临床心衰事件的关系

4774位受试者,平均75.4岁,58%的女性,20%的黑人。中位随访了8.6年,共记录了470例心衰事件。对于B期受试者,与血糖控制良好或无糖尿病的个体相比,HbA1c≥7%的个体发生临床心衰时往往更年轻(平均年龄:80岁 vs 83岁 vs 82岁,p<0.001)。与A期受试者相比,HbA1c≥7%与B期受试者心衰风险的相关性更强(HR:1.83 vs 1.52)。在亚临床心衰和HbA1C的交叉分类中,B期和HbA1c≥7%的受试者的心衰进展风险显著高于无糖尿病的A期亚临床心衰个体(HR 7.56)。


根据HbA1c、糖尿病和亚临床心衰分类的心衰发生率

总而言之,在亚临床心衰的老年人中,控制不佳的糖尿病与心衰进展的高风险密切相关。该研究结果强调了对亚临床心衰患者血糖控制的重要性。

 

原始出处:

Echouffo-Tcheugui Justin B,Ndumele Chiadi E,Zhang Sui et al. Diabetes and Progression of Heart?Failure: The Atherosclerosis Risk In Communities (ARIC) Study.[J] .J Am Coll Cardiol, 2022, 79: 2285-2293.

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    2023-01-21 hbwxf
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    2022-06-16 hbwxf
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1855065, encodeId=0d8c185506527, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Jan 21 11:22:34 CST 2023, time=2023-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261236, encodeId=fd31126123651, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu Jun 16 11:22:34 CST 2022, time=2022-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326958, encodeId=5af81326958eb, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Jun 16 11:22:34 CST 2022, time=2022-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1247317, encodeId=46e3124e3179b, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Jun 14 23:22:34 CST 2022, time=2022-06-14, status=1, ipAttribution=)]
    2022-06-14 jingjing

    大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等

    0

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