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首页> 外文期刊>The American Journal of Cardiology >Influence of diabetes mellitus and hyperglycemia on prognosis in patients > or =70 years old with heart failure and effects of nebivolol (data from the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with heart failure (SENIORS)).
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Influence of diabetes mellitus and hyperglycemia on prognosis in patients > or =70 years old with heart failure and effects of nebivolol (data from the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with heart failure (SENIORS)).

机译：糖尿病和高血糖对心衰≥70岁的患者预后的影响以及奈必洛尔的影响（奈必洛尔干预对心力衰竭老年人结局和住院治疗的影响研究数据）。

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The beneficial effects of beta blockers in younger patients with heart failure (HF) due to systolic dysfunction are well established. However, data from patients > or =70 years old with diabetes mellitus and HF are lacking. The Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with heart failure [SENIORS] tested the efficacy of the vasodilator beta blocker nebivolol in patients > or =70 years old with HF and impaired or preserved left ventricular ejection fraction. In the present analysis, we evaluated the association between diabetes mellitus and baseline glucose levels on the primary outcome (all-cause mortality and cardiovascular hospitalization) and secondary end points, including all-cause mortality, cardiovascular hospitalizations, and cardiovascular mortality. Of 2,128 patients, 555 (26.1%) had diabetes mellitus. Of the 555 patients with diabetes mellitus, 223 (40.2%) experienced the primary end point compared to 484 (30.8%) of the 1,573 nondiabetic patients (p <0.001). For the nondiabetic patients, the rate of the primary outcome for placebo compared to nebivolol was 33.7% for the placebo group and 27.8% for the nebivolol group (hazard ratio 0.78, 95% confidence interval 0.65 to 0.93; p = 0.006). In the diabetic subset, the rate was 40.3% for the placebo group and 40.1% for the nebivolol group (hazard ratio 1.04, 95% confidence interval 0.80 to 1.35, p = 0.773). The subgroup interaction p value was 0.073. The baseline glucose levels in the nondiabetic patients did not significantly affect the outcomes. The effect of diabetes mellitus on outcome was independent of the left ventricular ejection fraction and was most pronounced in those with HF due to a nonischemic etiology. In conclusion, in patients > or =70 years old with HF, diabetes mellitus was associated with a worse prognosis. Nebivolol was less effective in the patients with diabetes and HF than in those with HF but without diabetes who were > or =70 years old.
机译：众所周知，β受体阻滞剂对年轻的因收缩功能不全而导致的心力衰竭（HF）患者具有有益作用。但是，缺乏来自≥70岁的糖尿病和HF患者的数据。奈必洛尔干预对心力衰竭老年人结局和再次住院的影响的研究[SENIORS]测试了血管舒张剂β受体阻滞剂奈比洛尔在≥70岁的HF和左心室射血分数受损或保留的患者中的疗效。在目前的分析中，我们评估了糖尿病与基线血糖水平在主要结局（全因死亡率和心血管住院）和次要终点（包括全因死亡率，心血管住院和心血管死亡率）之间的关联。在2128位患者中，有555位（26.1％）患有糖尿病。在555名糖尿病患者中，有223名（40.2％）经历了主要终点，而在1,573名非糖尿病患者中有484名（30.8％）（p <0.001）。对于非糖尿病患者，安慰剂组与奈必洛尔相比主要结果的发生率为安慰剂组33.7％，奈必洛尔组27.8％（危险比0.78，95％置信区间0.65至0.93; p = 0.006）。在糖尿病亚组中，安慰剂组的比率为40.3％，奈比洛尔组的比率为40.1％（危险比1.04，95％置信区间0.80至1.35，p = 0.773）。亚组相互作用p值为0.073。非糖尿病患者的基线血糖水平并未显着影响预后。糖尿病对预后的影响与左心室射血分数无关，并且由于非缺血性病因，在患有HF的患者中最明显。总之，在≥70岁的HF患者中，糖尿病与预后较差有关。奈比洛尔在患有糖尿病和心力衰竭的患者中的疗效不及那些患有心力衰竭但≥70岁的糖尿病患者。

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