Prognostic value of resting heart rate on cardiovascular and renal outcomes in type 2 diabetic patients: a competing risk analysis in a prospective cohort.

Abstract:

OBJECTIVE:Epidemiological studies and randomized clinical trials have demonstrated in various populations that resting heart rate (RHR) was an independent predictor of cardiovascular (CV) risk and all-cause mortality. However, few data specifically evaluated the relationship between RHR and long-term CV and renal complications in a large population of type 2 diabetic (T2D) patients. RESEARCH DESIGN AND METHODS:We performed a single-center, prospective analysis in 1,088 T2D patients. RHR was determined at baseline by electrocardiogram. The primary outcome was a composite criterion of CV and renal morbi-mortality (CV death, nonfatal myocardial infarction and/or stroke, hospitalization for heart failure, renal replacement therapy), which was adjusted for death from non-CV cause as a competing event. The secondary outcome was a renal composite criterion (renal replacement therapy or doubling of baseline serum creatinine) adjusted for all-cause death as a competing event. RESULTS:During median follow-up of 4.2 years, 253 patients (23%) and 62 patients (6%) experienced the primary and secondary outcomes, respectively. In the subgroup of patients with CV disease history at baseline (n = 336), RHR was found to be associated with the incidence of primary outcome (P = 0.0002) but also with renal risk alone, adjusted for all-cause death as a competing event (secondary outcome; P < 0.0001). In patients without history of CV disease, no relation was found between RHR and the incidence of CV and/or renal events. CONCLUSIONS:In the real-life setting, RHR constitutes an easy and less time-consuming factor that would permit identification of CV disease diabetic patients with an increased risk for long-term CV and renal complications.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Miot A,Ragot S,Hammi W,Saulnier PJ,Sosner P,Piguel X,Torremocha F,Marechaud R,Hadjadj S

doi

10.2337/dc11-2468

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

2069-75

issue

10

eissn

0149-5992

issn

1935-5548

pii

dc11-2468

journal_volume

35

pub_type

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