Abstract 18551: Predictors of Heart Failure and Death in a High Risk Diabetic Population: The DAVID-Berg Study

Autor: Mauro Gori, Paolo Canova, Alice Calabrese, Giovanni Cioffi, Attilio Iacovoni, Aurelia Grosu, Alessandra Fontana, Paola Ferrari, Renata De Maria, Filippo Taddei, Alessandro Filippi, Maria Rosaria Rutili, Luigi Donzelli, Marina Parolini, Antonello Gavazzi, Michele Senni
Rok vydání: 2014
Předmět:
Zdroj: Circulation. 130
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circ.130.suppl_2.18551
Popis: Introduction: Diabetic subjects are at high risk of heart failure (HF) and death. Few data are available on the predictive value of NTproBNP, ECG, and echocardiogram in this population Hypothesis: A screening strategy with NTproBNP, ECG, and echo may improve prediction of HF/death events in a diabetic population in HF-stages A & B, beyond clinical data Methods: In 2008, among 4047 subjects aged >55 and Recently data on HF/death events have been prospectively collected for all diabetic subjects included in the study (n=198) Results: Median age of the study population was 69 yrs, 62% were men, mostly hypertensive (86%) with known cardiovascular disease (44%). During a median follow-up of 5.2 [4.9,5.5] yrs there were 45 HF/death. At Cox regression analyses univariate predictors of events were known cardiovascular disease, insulin therapy, chronic kidney dysfunction (CKD), NTproBNP≥300 pg/mL, abnormal ECG (atrial fibrillation &/or LV hypertrophy &/or bundle branch block &/or Q wave), left atrial volume index (LAVI)≥40 mL/m 2 , LV ejection fraction (LVEF)≤55%, and LV mass index. At multivariate analyses (stepwise forward selection applied to univariate predictors), clinical variables (CKD and known cardiovascular disease), ECG (HR 2.66 [95% CI 1.08-6.55]), LAVI≥40 mL/m 2 (HR 2.50 [95% CI 1.28-4.89]), and LVEF≤55% (HR 2.70 [95% CI 1.45-5.04]) remained significantly associated with the outcome. Adding sequentially NTproBNP, ECG, and echo (LAVI, LVEF) to clinical data improved event prediction (Figure) Conclusions: High risk diabetic subjects may be correctly risk stratified integrating sequentially clinical data with NTproBNP, ECG, and echocardiogram
Databáze: OpenAIRE
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