Abstract 17157: Clinical Prediction of Incident Heart Failure in Type 2 Diabetes Mellitus in 507,637 Patients: a Systematic Review and Meta-analysis
Background: Heart failure (CHF) is a major cause of death and disability in pts with type 2 diabetes mellitus (T2DM). Early treatment may improve the prognosis. This study sought to improve the assessment of HF risk in pts with T2DM [[Unable to Display Character: –]] a step that would be critical for effective HF screening.
Methods: A systematic literature search was performed on electronic databases including MEDLINE and EMBASE, using MeSH terms ‘heart failure’, ‘risk factor’, ‘T2DM’, ‘cardiac dysfunction’, ‘stage B heart failure’, ‘incident heart failure’, ‘risk assessment’, ‘risk impact’, ‘risk score’, ‘predictor’, ’prediction’ and related free text terms. The search was limited to human studies in full-length publications in English language journal from 1946 to 2014.Univariate relative risk (RR) and hazard ratio (HR) were derived or abstracted from each study.
Results: Twenty-one studies (n=1,111,569, including 507,637 subjects with T2DM) were included in this analysis with a follow-up ranging from 1 to 12 years. Risk variables reported ≤3 times were included in this meta-analysis; the pooled relative risk for incident HF among patients with T2DM ranged from 1.5-2.5 for atherosclerotic vascular disease (coronary, cerebrovascular, peripheral), use of insulin and thiazolidinediones and hypertension (Table). For risks reported in hazard ratio, the association was greater in insulin use (2.22; 1.82-2.71), followed by 5 years increase in age (1.47; 1.25-1.73) and fasting glucose (1.28; 1.10-1.51 per standard deviation).
Conclusion: The overall results of this meta-analysis showed that among patients with T2DM, 11 common clinical variables are associated with significantly increased risk of incident HF.
Table 1. Effect size of risk factors of incident heart failure in T2DM.
Author Disclosures: Y. Wang: None. T. Negishi: None. K. Negishi: None. T.H. Marwick: None.
- © 2014 by American Heart Association, Inc.