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Glycemic Status and Incident Heart Failure in Elderly Without History of Diabetes Mellitus: The Health, Aging, and Body Composition Study.

Authors :
Kalogeropoulos, Andreas
Georgiopoulou, Vasiliki
Harris, Tamara B.
Kritchevsky, Stephen B.
Bauer, Douglas C.
Smith, Andrew L.
Strotmeyer, Elsa
Newman, Anne B.
Wilson, Peter W.F.
Psaty, Bruce M.
Butler, Javed
Source :
Journal of Cardiac Failure; Sep2009, Vol. 15 Issue 7, p593-599, 7p
Publication Year :
2009

Abstract

Abstract: Background: It is unclear whether measures of glycemic status beyond fasting glucose (FG) levels improve incident heart failure (HF) prediction in patients without history of diabetes mellitus (DM). Methods and Results: The association of measures of glycemic status at baseline (including FG, oral glucose tolerance testing [OGTT], fasting insulin, hemoglobin A<subscript>1c</subscript> [HbA<subscript>1c</subscript>] levels, and homeostasis model assessment of insulin resistance [HOMA-IR] and insulin secretion [HOMA-B]) with incident HF, defined as hospitalization for new-onset HF, was evaluated in 2386 elderly participants without history of DM enrolled in the Health, Aging, and Body Composition Study (median age, 73 years; 47.6% men; 62.5% white, 37.5% black) using Cox models. After a median follow-up of 7.2 years, 185 (7.8%) participants developed HF. Incident HF rate was 10.7 cases per 1000 person-years with FG <100mg/dL, 13.1 with FG 100–125mg/dL, and 26.6 with FG ≥126mg/dL (P =.002; P =.003 for trend). In adjusted models (for body mass index, age, history of coronary artery disease and smoking, left ventricular hypertrophy, systolic blood pressure and heart rate [HR], and creatinine and albumin levels), FG was the strongest predictor of incident HF (adjusted HR per 10mg/dL, 1.10; 95% CI, 1.02–1.18; P =.009); the addition of OGTT, fasting insulin, HbA<subscript>1c</subscript>, HOMA-IR, or HOMA-B did not improve HF prediction. Results were similar across race and gender. When only HF with left ventricular ejection fraction (LVEF) ≤40% was considered (n=69), FG showed a strong association in adjusted models (HR per 10mg/dL, 1.15; 95% CI, 1.03–1.29; P =.01). In comparison, when only HF with LVEF >40%, was considered (n=71), the association was weaker (HR per 10mg/dL, 1.05; 95% CI; 0.94–1.18; P =.41). Conclusions: Fasting glucose is a strong predictor of HF risk in elderly without history of DM. Other glycemic measures provide no incremental prediction information. [Copyright &y& Elsevier]

Details

Language :
English
ISSN :
10719164
Volume :
15
Issue :
7
Database :
Supplemental Index
Journal :
Journal of Cardiac Failure
Publication Type :
Academic Journal
Accession number :
43876023
Full Text :
https://doi.org/10.1016/j.cardfail.2009.03.001