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Diabetic retinopathy and risk of heart failure.

Abstract：

OBJECTIVES:The purpose of this study was to examine the association of diabetic retinopathy with incident heart failure (HF). BACKGROUND:Microvascular disease might play a more prominent role in the pathogenesis of diabetic cardiomyopathy, a major cause of HF in diabetes. Whether diabetic retinopathy, a microvascular complication of diabetes, predicts HF is unclear. METHODS:A population-based study included 1,021 middle-aged type 2 diabetic persons with normal renal function and free of clinical coronary heart disease or HF at baseline. Diabetic retinopathy signs were graded from retinal photographs. Incident HF events were prospectively identified from hospital stay and death records. RESULTS:There were 125 (12.8%) participants with diabetic retinopathy. After 9-year follow-up, 106 (10.1%) participants developed incident HF events. Persons with retinopathy were more likely to develop HF (cumulative incidence of 21.6%) than those without retinopathy (cumulative incidence of 8.5%). After controlling for age, gender, race, smoking, diabetes duration, insulin use, blood pressure, lipid profile, and other risk factors, participants with retinopathy had more than 2.5-fold higher risk of developing HF than those without retinopathy (hazard ratio [HR] 2.71; 95% confidence interval [CI] 1.46 to 5.05). This association remained significant after further adjustments for glycemic control, carotid atherosclerosis, and serum markers of endothelial dysfunction (HR 2.20, 95% CI 1.08 to 4.47). CONCLUSIONS:The presence of diabetic retinopathy signifies an excess risk of HF, independent of known risk factors. This further supports a contribution of microvascular disease to the development of HF in people with diabetes.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Cheung N,Wang JJ,Rogers SL,Brancati F,Klein R,Sharrett AR,Wong TY,ARIC (Atherosclerosis Risk In Communities) Study Investigators.

doi

10.1016/j.jacc.2007.11.076

subject

Has Abstract

pub_date

2008-04-22 00:00:00

pages

1573-8

issue

16

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(08)00451-8

journal_volume

51

pub_type

杂志文章

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