06 Sep Diabetes and Heart Failure After Acute Myocardial Infarction: The FAST-MI Programme
MedicalResearch.com Interview with:
Nicolas Danchin MD, FESC
Professor of Medicine, Consultant Cardiologist
Intensive Cardiac Care Unit
Hôpital Européen Georges Pompidou
MedicalResearch.com: What is the background for this study?
Response: FAST-MI is a programme of nationwide French surveys, carried out every 5 years in France since 2005 in patients hospitalised with STEMI or NSTEMI. Patients are included consecutively for one month and 10-year follow-up is organized. We can thus analyse patients’ outcomes in relation with their profile. Knowing that diabetic patients represent a large proportion of patients with AMI, we thought it would be worthwhile determining whether they suffered specific complications, and in particular, heart failure, both at the acute stage and in the subsequent months.
MedicalResearch.com: What are the main findings?
Response: We found that diabetic patients were at increased risk of developing heart failure at the acute stage, (29% versus 15% in non-diabetic patients, adjusted hazard ratio 1.64, P<0.001). Also, among patients discharged alive and who had not developed heart failure at the acute stage, diabetic patients had an increased risk of being hospitalised with HF in the following year (adjusted HR 1.70, P=0.002).
Finally, among patients alive at one year, those who had been hospitalised for non-fatal HF had a 40% mortality at 5 years versus 14.5% for non-diabetic patients who had not been hospitalised for HF (adjusted HR 2.11, P=0.008).
MedicalResearch.com: What should readers take away from your report?
Response: Two simple messages: diabetic patients are more prone to developing heart failure, so that it is particularly important to develop strategies for preventing, or at least for the early detection of heart failure in these patients.
The second message is that mortality for diabetic patients who develop heart failure in the months following an acute AMI are considerable risk of death in the subsequent years (40% mortality at 5 years), so that both HF prevention and treatment should be the aim of management for diabetic patients who have an MI.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: I think that strategies to prevent the occurrence of heart failure in diabetic patients sustaining an AMI should be tested in clinical trials (e.g. testing the preventive use of medications such as sGLT2 inhibitors in this context).
MedicalResearch.com: Is there anything else you would like to add?
Response: A final word to insist that observational data can bring invaluable information to better understand the natural history or pathophysiology of diseases.
The FAST-MI programme has been funded by a consortium of pharma industry including Amgen, Asneca, Bayer, BMS, Daiichi Sankyo, Eli Lilly, GSK, MSD, Novartis, Pfizer, Sanofi and Servier.
ESC (EUROPEAN SOCIETY OF CARDIOLOGY)
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