Abstract 3926: Diabetes is not Appropriately Managed Even in the Very High Risk Patients with Heart Failure. Data from the GISSI Heart Failure Trial
Aims. Controlled studies have convincingly demonstrated that preventive strategies aimed to control traditional risk factors improve prognosis of patients with diabetes (D). The purpose of this analysis was to evaluate how frequently patients with D and chronic heart failure (CHF) comply with the guidelines recommended targets for risk factor control.
Methods. Analyses were performed in 7046 patients with CHF enrolled in the GISSI-HF trial. Diagnosis of D was clinically defined by cardiologist enrolling the patient. The following targets have been considered: LDL cholesterol <100 mg/dL, systolic blood pressure (SBP) <130/80 mmHg, glucose levels <110 mg/dL, Hb1As <6.5%.
Results. D was reported in 2080/7046 patients (28.5%). Patients with D had significantly more frequently comorbidities than no-D patients (COPD, renal dysfunction, prior stroke, peripheral artery disease, hypertension, anemia). The rate of use of betablockers was lower in D than in no-D, while no differences were observed in the prescription of ACE-I/ARBs. Complete information regarding all risk factor measures were available for 1594 patients with D. Figure⇓ shows the rate of patients reaching the recommended targets.
Conclusion. Patients with D, even in a very high risk condition such as CHF, are not appropriately managed. These findings:
raise concerns regarding the applicability of current guidelines in clinical practice,
further support the need for trials in CHF aimed at improving patient outcomes with specific, intensive management of D.