Outcomes in diabetic vs nondiabetic patients requiring cardiac resynchronization therapy for heart failure: A meta-analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Aman Goyal MD , Muhammad Daoud Tariq MBBS , Abdul Moiz Khan MBBS , Sonia Hurjkaliani MBBS , Areeba Ahsan MBBS , Humza Saeed MBBS , Rhea Trivedi MBBS , Gauranga Mahalwar MD , Mohamed Daoud MD , Agastya D. Belur MD
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引用次数: 0

Abstract

Background

Heart failure (HF) affects millions globally, causing severe symptoms and poor prognosis. Cardiac resynchronization therapy (CRT) has been shown to improve heart function and quality of life in HF patients with electrical dyssynchrony, but its effectiveness in diabetic patients remains unclear due to the complexities associated with diabetes.

Objective

This study evaluates the impact of diabetes mellitus on CRT by comparing outcomes between diabetic and nondiabetic patients through a meta-analysis.

Methods

A comprehensive literature search identified studies on CRT in HF patients both with and without diabetes mellitus. Pooled risk ratios (RRs) and mean differences were calculated using a random-effects model with 95% confidence intervals and statistical significance set at P < .05.

Results

Analysis of 13 observational studies involving 20,073 participants revealed that diabetic patients had a significantly increased risk of all-cause mortality (RR 1.34, P < .00001) and cardiovascular death (RR 1.49, P = .002) compared with nondiabetic patients. However, no statistically significant differences were observed between groups in the risk of stroke (RR 3.99, P = .05), myocardial infarction (RR 1.16, P = .30), changes in left ventricular (LV) ejection fraction (P = .22), LV end-systolic volume (P = .10), and LV end-diastolic volume (P = .63).

Conclusion

These findings suggest that diabetic patients undergoing CRT face a higher risk of all-cause and cardiovascular mortality compared with nondiabetic patients. The increased mortality risk highlights the need for tailored treatment strategies, emphasizing the judicious use of CRT in diabetic patients.
需要心脏再同步化治疗心力衰竭的糖尿病患者与非糖尿病患者的结局:一项荟萃分析
心力衰竭(HF)影响全球数百万人,导致严重症状和预后不良。心脏再同步化治疗(CRT)已被证明可以改善心功能和心电非同步化心衰患者的生活质量,但由于与糖尿病相关的复杂性,其对糖尿病患者的有效性尚不清楚。目的通过meta分析比较糖尿病和非糖尿病患者的预后,评价糖尿病对CRT的影响。方法综合文献检索合并和不合并糖尿病的HF患者的CRT研究。合并风险比(rr)和平均差异采用随机效应模型计算,95%置信区间和统计学显著性设置为P <;. 05。结果对13项观察性研究(涉及20,073名受试者)的分析显示,糖尿病患者的全因死亡风险显著增加(RR 1.34, P <;.00001)和心血管死亡(RR 1.49, P = .002)。然而,在卒中(RR 3.99, P = 0.05)、心肌梗死(RR 1.16, P = 0.30)、左室射血分数(P = 0.22)、左室收缩末期容积(P = 0.10)和左室舒张末期容积(P = 0.63)的风险方面,组间差异无统计学意义。结论与非糖尿病患者相比,接受CRT治疗的糖尿病患者有更高的全因死亡率和心血管死亡率。增加的死亡风险强调了量身定制治疗策略的必要性,强调了在糖尿病患者中明智地使用CRT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
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0
审稿时长
52 days
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