Development of Congestive Heart Failure in Type 2 Diabetic Patients With Microalbuminuria or Proteinuria
- 1 March 2003
- journal article
- clinical trial
- Published by American Diabetes Association in Diabetes Care
- Vol. 26 (3), 855-860
- https://doi.org/10.2337/diacare.26.3.855
Abstract
OBJECTIVE—The DIABHYCAR (type 2 DIABetes, Hypertension, CArdiovascular Events and Ramipril) study allowed investigators to analyze factors leading to the development of congestive heart failure (CHF) in type 2 diabetic patients with abnormal urinary albumin concentration. RESEARCH DESIGN AND METHODS—Type 2 diabetic subjects of both sexes aged ≥50 years who had a urinary albumin concentration ≥20 mg/l were randomly allocated to 1.25 mg/day ramipril or placebo in addition to their usual treatment and treated for 3–6 years in a double-blind fashion. Major outcomes including hospitalization for CHF were recorded during the follow-up. RESULTS—Of the 4,912 included patients, 187 developed CHF during the study. There was no significant difference in the incidence of CHF between the two treatment groups. Using a multivariate analysis, independent risk factors for the occurrence of CHF were age, history of cardiovascular disease, baseline urinary albumin concentration, baseline HbA1c, and smoking habits. A total of 68 of the 187 patients (36.4%) died during the 12 ± 11-month period after the first hospitalization for CHF, whereas the annual mortality rate of the population who did not develop CHF was 3.2%. CONCLUSIONS—Presence of atherosclerotic disease, baseline urinary albumin concentration, and HbA1c level were indicators for further development of CHF. Occurrence of CHF is a major prognostic turn in a diabetic patient’s life.Keywords
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