Heart failure therapy in diabetic patients-comparison with the recent ESC-EASD guidelineReport as inadecuate




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Cardiovascular Diabetology

, 10:15

First Online: 08 February 2011Received: 13 December 2010Accepted: 08 February 2011

Abstract

BackgroundTo assess heart failure therapies in diabetic patients with preserved as compared to impaired systolic ventricular function.

Methods3304 patients with heart failure from 9 different studies were included mean age 63 ± 14 years; out of these, 711 subjects had preserved left ventricular ejection fraction ≥ 50% and 994 patients in the whole cohort suffered from diabetes.

ResultsThe majority >90% of heart failure patients with reduced ejection fraction SHF and diabetes were treated with an ACE inhibitor ACEi or angiotensin receptor blocker ARB or with beta-blockers. By contrast, patients with diabetes and preserved ejection fraction HFNEF were less likely to receive these substance classes p < 0.001 and had a worse blood pressure control p < 0.001. In comparison to patients without diabetes, the probability to receive these therapies was increased in diabetic HFNEF patients p < 0.001, but not in diabetic SHF patients. Aldosterone receptor blockers were given more often to diabetic patients with reduced ejection fraction p < 0.001, and the presence and severity of diabetes decreased the probability to receive this substance class, irrespective of renal function.

ConclusionsDiabetic patients with HFNEF received less heart failure medication and showed a poorer control of blood pressure as compared to diabetic patients with SHF. SHF patients with diabetes were less likely to receive aldosterone receptor blocker therapy, irrespective of renal function.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-10-15 contains supplementary material, which is available to authorized users.

Frank Edelmann, Rolf Wachter contributed equally to this work.

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Author: Frank Edelmann - Rolf Wachter - Hans-Dirk Düngen - Stefan Störk - Annette Richter - Raoul Stahrenberg - Till Neumann - Cl

Source: https://link.springer.com/article/10.1186/1475-2840-10-15







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