Prognostic Impact of Diabetes Mellitus in Chronic Heart Failure According to Presence of Ischemic Heart Disease – With Special Reference to Nephropathy –
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- Miura Masanobu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Sakata Yasuhiko
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Miyata Satoshi
- Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Nochioka Kotaro
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Takada Tsuyoshi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Tadaki Soichiro
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Ushigome Ryoichi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Yamauchi Takeshi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Sato Kenjiro
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Onose Takeo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Tsuji Kanako
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Abe Ruri
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Takahashi Jun
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Shimokawa Hiroaki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Background:It is unclear whether the prognostic impact of diabetes mellitus (DM) in chronic heart failure (CHF) is influenced by ischemic heart disease (IHD) and/or nephropathy.Methods and Results:We enrolled 4,065 consecutive patients with stage C/D CHF (mean age, 69.0 years; 68.7% male) in the CHART-2 Study (n=10,219). We defined DM as current history of DM treatment or HbA1c ≥6.5% (National Glycohemoglobin Standardization Program [NGSP]), and nephropathy as urine albumin:creatinine ratio ≥30 mg/g or urine dipstick test ≥(±) at enrollment. Impacts of DM and nephropathy on the composite of death, myocardial infarction, stroke, and HF admission were examined. Among the 4,065 patients, 1,448 (35.6%) had DM, while IHD and nephropathy were also noted in 1,644 (40.4%) and in 1,549 (38.1%), respectively. During the median follow-up of 2.88 years, 1,025 (25.2%) reached the composite endpoint. On multivariate Cox regression, DM was significantly associated with the composite endpoint in all patients (HR, 1.17; P=0.02), and in those with IHD (HR, 1.38; P=0.004), but not in those without IHD (HR, 1.12; P=0.22; P for interaction=0.12). Furthermore, when the patients were stratified by nephropathy, DM was associated with worse prognosis only in the IHD patients with nephropathy.Conclusions:The prognostic impact of DM was more evident in patients with IHD than in those without IHD, particularly when complicated with nephropathy. (Circ J 2015; 79: 1764–1772)
収録刊行物
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- Circulation Journal
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Circulation Journal 79 (8), 1764-1772, 2015
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390282680083921024
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- NII論文ID
- 130005089372
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 026602641
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- PubMed
- 26004750
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
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