Clinical InvestigationCongestive Heart FailureInfluence of diabetes on characteristics and outcomes in patients hospitalized with heart failure: A report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)
Section snippets
Methods
The OPTIMIZE-HF was a comprehensive hospital-based registry and process-of-case improvement program designed to provide optimal medical care and education to patients hospitalized for HF. The OPTIMIZE-HF program has been described in detail elsewhere17, 18, 19 and will be briefly summarized below.
Patient comparison
This analysis included 48,612 patients at 259 hospitals, with follow-up data from 5791 patients. Among patients hospitalized for HF, 42% had diabetes (n = 20,162). Of these patients with DM, 40% were treated with insulin (n = 8058). The overall registry population was elderly, with a mean age of 73.2 years, and patients with DM were slightly younger than their nondiabetic counterparts (71.5 ± 12.2 vs 74.4 ± 15.0 years; P < .0001). Diabetic patients were more likely to have an ischemic etiology,
Discussion
This analysis from OPTIMIZE-HF demonstrates that a very high prevalence of DM exists among hospitalized patients with HF, with 42% of those enrolled having DM documented. A prevalence similar to that of the current study has also been observed in the Acute Decompensated Heart Failure National Registry, which showed that 44% of hospitalized patients with HF have DM.20 In the Enhanced Feedback for Effective Cardiac Treatment study of 4031 community-based patients presenting with new onset HF at
References (26)
- et al.
Role of diabetes in congestive heart failure: the Framingham study
Am J Cardiol
(1974) - et al.
Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): randomised controlled trial
Lancet
(2003) - et al.
Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial—the Losartan Heart Failure Survival Study ELITE II
Lancet
(2000) - et al.
Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial
Lancet
(2003) - et al.
Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status. A meta-analysis of major clinical trials
J Am Coll Cardiol
(2003) - et al.
Efficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: experiences from MERIT-HF
Am Heart J
(2005) - et al.
Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design
Am Heart J
(2004) - et al.
Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)
Am Heart J
(2005) - et al.
Diabetes mellitus, a predictor of morbidity and mortality in the Studies of Left Ventricular Dysfunction (SOLVD) trials and registry
Am J Cardiol
(1996) - et al.
Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure
J Am Coll Cardiol
(2004)
The effect of diabetes on outcomes of patients with advanced heart failure in the BEST trial
J Am Coll Cardiol
Prognostic impact of diabetes mellitus in patients with heart failure according to the etiology of left ventricular systolic dysfunction
J Am Coll Cardiol
Profile for estimating risk of heart failure
Arch Intern Med
Cited by (0)
The OPTIMIZE-HF registry and this study were supported by GlaxoSmithKline, Philadelphia, PA.
The OPTIMIZE-HF registry is registered: www.clinicaltrials.gov, study number NCT00344513.