Prediabetes tied to worse outcomes in HF patients with preserved ejection fraction: Study

UK: Recent data from the PARAGON-HF trial showed that pre-diabetes is common in heart failure with preserved ejection fraction (HFpEF) patients and is tied to a greater risk of heart failure hospitalizations (HFH) and worse clinical outcomes. The study was published in the European Journal of Heart Failure on 17 December 2021. 

Previous studies have shown an association between HFpEF and insulin resistance but not much is known about the diabetic continuum, and in particular about pre-diabetes, in HFpEF. John J.V. McMurray, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK, and colleagues, therefore, aimed to examine the characteristics and outcomes of participants with diabetes or pre-diabetes in PARAGON-HF.

The study included patients aged ≥50 years with left ventricular ejection fraction ≥45%, structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP). They were divided on the basis of glycated haemoglobin (HbA1c): (i) normal HbA1c, <6.0%; (ii) pre-diabetes, 6.0%–6.4%; (iii) diabetes, ≥6.5% or history of diabetes.

The primary outcome was a composite of cardiovascular (CV) death and total HFH. 

"Pre-diabetes is common in patients with HFpEF and is associated with worse clinical status and greater risk of HFH," the authors concluded.

Reference:

Jackson, A.M., Rørth, R., Liu, J., Kristensen, S.L., Anand, I.S., Claggett, B.L., Cleland, J.G., Chopra, V.K., Desai, A.S., Ge, J., Gong, J., Lam, C.S., Lefkowitz, M.P., Maggioni, A.P., Martinez, F., Packer, M., Pfeffer, M.A., Pieske, B., Redfield, M.M., Rizkala, A.R., Rouleau, J.L., Seferović, P.M., Tromp, J., Van Veldhuisen, D.J., Yilmaz, M.B., Zannad, F., Zile, M.R., Køber, L., Petrie, M.C., Jhund, P.S., Solomon, S.D., McMurray, J.J. and (2022), Diabetes and pre-diabetes in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. https://doi.org/10.1002/ejhf.2403