Table 4.
Comparison of patients, measurements, and outcomes with previous heart failure studies
| Reference | Number of patients | Study patients | Measurements | Outcomes |
|---|---|---|---|---|
| Prevalence of IGT or diabetes | ||||
| Suskin et al.1 | 663 | NYHA II–IV, EF < 40% | Fasting plasma glucose and insulin levels | 27%, diabetes; 8%, newly diagnosed diabetes; 9%, elevated glucose levels |
| Witteles et al.2 | 43 | Idiopathic dilated cardiomyopathy | OGTT | 49%, IGT |
| Kim et al.3 | 56 | Dilated cardiomyopathy | OGTT | 50%, IGT; 26.8%, newly diagnosed diabetes |
| Berry et al.4 | 454 | Acute HF | Plasma glucose level | 13%, IGT |
| Egstrup et al.5 | 413 | Outpatients with HF and LVEF ≤ 45% | OGTT | 23%, IGT; 18%, newly diagnosed diabetes |
| Present study | 535 | Chronic HF with a history of hypertension (82%; LVEF > 40%) | OGTT |
<At enrolment>23%, IGT; 0.5%, newly diagnosed diabetes <At 1 year>5%, newly diagnosed IGT; 2.5%, newly diagnosed diabetes |
| Prognostic significance of abnormalities in glucose regulation | ||||
| Doehner et al.6 | 105 (male) | Chronic HF | ivGTT | HR 0.28 (0.14–0.55, P = 0.0003) of insulin sensitivitya for all‐cause death |
| Gerstein et al.25 | 2412 | Chronic HF | HbA1c | HR 1.22 (1.16–1.29, P < 0.001) per 1% HbA1c increase for all‐cause death |
| Berry et al.4 | 454 | Acute HF | Plasma glucose level | HR 1.41 (0.92–2.16, P = 0.12) of IGT for all‐cause death |
| Kosiborod et al.7 | 50 532 | Post discharge after acute HF, Age > 65 years (retrospective) | Plasma glucose level | HR 1.00 (0.99–1.01, P = 0.75) for all‐cause mortality (per 10 mg/dL admission serum glucose increase) |
| Present study | 535 | Chronic HF with a history of hypertension (82%; LVEF > 40%) | OGTT |
HR 1.18 (1.05–1.33, P = 0.007) per 1% HbA1c increase for composite outcome HR 1.00 (0.61–1.64, P = 0.99) for IGT HR 2.25 (1.14–4.42, P = 0.019) for IGT complicated with albuminuria |
EF, ejection fraction; HbA1c, haemoglobin A1c; HF, heart failure; HR, hazard ratio; IGT, impaired glucose tolerance; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association; OGTT, oral glucose tolerance test.
Insulin sensitivity—the inverse of insulin resistance—is defined as the fraction of the glucose distribution space cleared per minute by insulin‐dependent glucose disposal relative to the concentration of insulin and is expressed in min/μU/mL.