Two other studies reported a prevalence of 11.8%, with the diagnosis of heart failure based on heart failure scores, without the use of echocardiography [ 7, 9].
Unplanned cardiovascular events were defined as follows: hospitalization based on heart failure, myocardial infarction or unstable angina, symptomatic bradycardia, atrial fibrillation, ventricular tachycardia, peripheral and central arterial occlusive disease, transient ischemic attack, or stroke.
Prevalent heart failure at baseline was assessed using a validated score, that was based on the heart failure definition of the European Society of Cardiology [ 18].
Structured home care, based on the Heart Failure at Home Model, was given once the patient had completed the baseline questionnaire.
§Scoring system based on congestive heart failure (1 point), hypertension (1 point), age ≥75 (2 points), diabetes (1 point), stroke/transient ischaemic attack/thromboembolism (2 points), vascular disease (1 point), age 65-74 (1 point), female (1 point).
To study the impact of diabetes and A1C on heart failure in the context of several potential confounders, we made a selection of the most important risk factors for heart failure based on recent guidelines (1, 2).
5, 6, 9, 10, 12, 13 This finding is not surprising, given that the NYHA classification is based on symptoms of heart failure and the physical limitations of the disease as experienced by patients, and thereby reflects their HRQOL.
CHADS2[ 19] stroke risk factors and total score(calculated based on presence of heart failure (HF), hypertension, diabetes, prior stroke/TIA, and age >75 years) and ATRIA [ 20] bleeding risk scores (calculated based on presence of anemia, severe renal disease, any prior hemorrhage diagnosis, hypertension, and age ≥75 years) were calculated for study cohorts.
17 Heart failure was assessed using a validated score based on the definition of heart failure by the European Society of Cardiology. 25 26 Prevalent diabetes mellitus was defined as a preload or postload serum glucose level of >11 mmol/L determined at a research visit or the use of hypoglycaemic medication.
Previously reported heart failure prevalence estimates in patients with type 2 diabetes were based on medical records or heart failure scores, lacking echocardiography in all patients.
Heart failure will be based on hospitalizations for a clinical heart failure syndrome using relevant discharge diagnosis codes and confirmed based on Framingham Heart Study clinical criteria ascertained from medical records [ 45].
