Compared Impact of Diabetes on the Risk of Heart Failure from Acute Myocardial Infarction to Chronic Coronary Artery Disease - 03/07/21

Doi : 10.1016/j.diabet.2021.101265

Gilles Lemesle, MD *, ^⁎ , Etienne Puymirat, MD ^†, Laurent Bonello, MD ^‡, Tabassome Simon, MD ^§, Philippe-Gabriel Steg, MD ^||, Jean Ferrières, MD ^¶, François Schiele, MD ^#, Laurent Fauchier, MD ^⁎⁎, Patrick Henry, MD ^††, Guillaume Schurtz, MD ^‡‡, Sandro Ninni, MD *, Nicolas Lamblin, MD ^§§, Christophe Bauters, MD ^§§, Nicolas Danchin, MD ^†
^⁎ Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France. Univ. Lille, F-59000, France. Institut Pasteur of Lille, Inserm U1011, F-59000 Lille, France. FACT (French Alliance for Cardiovascular Trials), F-75000 Paris, France
^† Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, and FACT (French Alliance for Cardiovascular Trials), Paris, France
^‡ Aix-Marseille Univ, Intensive care unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Centre for CardioVascular and Nutrition research (C2VN), INSERM 1263, INRA 1260, Marseille, France
^§ Department of Pharmacology and URCEST, Hôpital St Antoine, University of Paris Sorbonne, and FACT (French Alliance for Cardiovascular Trials), Paris, France
^|| Department of Cardiology, Hôpital Bichat, AP-HP, University of Paris, and FACT (French Alliance for Cardiovascular Trials), Paris, France
^¶ Department of Cardiology, Rangueil hospital, 31400 Toulouse, France
^# Department of Cardiology, university hospital Jean-Minjoz, 25000 Besançon, France
^⁎⁎ Department of Cardiology, CHU de Trousseau, University François-Rabelais, 37170 Chambray-lès-Tours, France
^†† Cardiology Department, APHP, Lariboisière Hospital, Paris, France. University of Paris, Paris, France
^‡‡ Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France
^§§ Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France. Univ. Lille, F-59000, France. Institut Pasteur of Lille, Inserm U1167, F-59000 Lille, France

¹Address for correspondence: Pr Gilles Lemesle, Service USIC et Centre Hémodynamique, Institut Cœur Poumon, CHU de Lille, 59037 Lille Cedex, France, Phone +33 320445330, Fax +33 320444898Service USIC et Centre HémodynamiqueInstitut Cœur PoumonCHU de LilleLille Cedex59037France

En prensa. Manuscrito Aceptado. Disponible en línea desde el Saturday 03 July 2021
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ABSTRACT

Aim

. - We attempted to describe the risk of heart failure (HF) occurrence according to diabetes mellitus (DM) status in patients with coronary artery disease (CAD) over time, from acute myocardial infarction (MI) to the chronic stable phase.

Methods

. - For the acute and subacute MI phases, we analysed the FAST-MI cohort restricted to patients without history of HF (n=12,473). The analysis on 1-year outcomes after MI was further restricted to patients who were discharged alive and without history of HF and/or HF symptoms during the index hospitalisation for MI (n=9,181). To analyse the chronic phase, we analysed the CORONOR cohort restricted to patients without history of HF (n=3,871). The primary endpoint was HF occurrence according to DM status. We also analysed the composite of all-cause death or HF.

Results

. – Killip-Kimball class ≥II during the index MI hospitalisation was more frequent in DM patients compared to non-DM patients (29% vs. 15.3%, adjusted OR=1.60). At one year after MI, hospitalisation for HF was more frequent in DM patients (3.3% vs. 1.2%, adjusted HR=1.73). At the chronic phase (5-year outcomes), hospitalisation for HF was more frequent in DM patients (8.5% vs. 4.3%, adjusted HR=1.70). Results focusing on the composite endpoint (all-cause death or HF) were consistent.

Conclusion

. - DM was associated with a very constant near 2-fold increase in the risk of HF whatever the presentation of CAD. Avoiding the risk of HF occurrence in CAD patients with DM is critical in daily practice and should be a constant life-long endeavour.

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Keywords : Coronary artery disease, Diabetes mellitus, Heart failure, Myocardial infarction