Glycemic control and clinical outcomes in diabetic patients with heart failure and reduced ejection fraction: insight from ventricular remodeling using cardiac MRI
Authors' conclusion
We showed a U-shaped association of glycemic control with clinical outcomes in patients with T2DM and HFrEF, with the lowest risk of adverse outcomes among patients with modest glycemic control. HbA1c between 6.5% and 7.5% may be served as the optimal hypoglycemic target in this specific population.
Study context
- Population
- Patients with T2D and heart failure with reduced ejection fraction (HFrEF) who underwent cardiac MRI
- Participants
- 262 patients
- Exposure
- HbA1c <6.5% and HbA1c >7.5% vs HbA1c 6.5-7.5%
- Outcome
- Primary outcomes
- Follow-up
- Median 35.0 months
Methodological detailscardiac MRI
- Cardiac MRI
Main finding
As reported in the abstract
Each group vs modest controlHazard ratio (95% CI)P value
Intensive control
2.42(1.07–5.45)
P = 0.033Poor control
2.24(1.01–4.99)
P = 0.038- Patients with at least one confirmed endpoint event
- 55 patients (21.0%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Secondary outcomes · median follow-up 35.0 monthsIntensive controlvs Modest controlCox multivariable analysis | 2.84 (1.16–6.96) | P = 0.022 | |
| Secondary outcomes · median follow-up 35.0 monthsPoor controlvs Modest controlCox multivariable analysis | 2.65 (1.08–6.50) | P = 0.038 | |
| 0.10.31310Hazard ratio (log scale) |
Left ventricular (LV) longitudinal systolic strain
- Despite similar biventricular ejection fractions, intensive and poor glycemic control showed prominent deterioration of LV longitudinal systolic strain
- P = 0.004
Original publication
Glycemic control and clinical outcomes in diabetic patients with heart failure and reduced ejection fraction: insight from ventricular remodeling using cardiac MRI. Cardiovasc Diabetol. Published 29 April 2024. doi:10.
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