{"id":"94ee18bf56a5","type":"article","url":"https://hartvaat.nl/2019/12/01/gestoorde-glucosetolerantie-en-albuminurie-bij-chronisch-hf-support-trial/","title":"Gestoorde glucosetolerantie en albuminurie bij chronisch HF: SUPPORT-trial","title_en":"Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["anemie-ckd","answer-hf","chronische-nierziekte","dapa-hf","diabetes-en-hart","fidelio-dkd","figaro-dkd","flow-trial","select-trial","soul-trial","step-hfpef","summit-trial","vrouwen"],"journal":"ESC heart failure","doi":"10.1002/ehf2.12516","source_url":"https://doi.org/10.1002/ehf2.12516","authors":["Kotaro Nochioka","Yasuhiko Sakata","Masanobu Miura","Takashi Shiroto","Jun Takahashi","Chie Saga","Yasuko Ikeno","Nobuyuki Shiba","Tsuyoshi Shinozaki","Masafumi Sugi","Makoto Nakagawa","Tatsuya Komaru","Atsushi Kato","Eiji Nozaki","Kaoru Iwabuchi","Tetsuya Hiramoto","Kanichi Inoue","Masatoshi Ohe","Kenji Tamaki","Ichiro Tsuji","Hiroaki Shimokawa"],"significance":5,"published":"2019-12-01","source_date":"2019-12-01","image":"","kennis":[],"congress":"","summary_en":"This SUPPORT subanalysis evaluated the prevalence and prognostic significance of impaired glucose tolerance and albuminuria in chronic heart failure, identifying metabolic and renal markers of adverse prognosis.","created":"2026-07-03T10:28:18Z","updated":"2026-07-03T13:27:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"SUPPORT subanalyse naar de prevalentie en klinische impact van gestoorde glucosetolerantie en albuminurie bij chronisch hartfalen.","abstract_original":"AIMS: The study aims to evaluate the prognostic significance of impaired glucose tolerance (IGT) with reference to albuminuria in patients with chronic heart failure (CHF). METHODS AND RESULTS: We examined 535 CHF patients (mean 66 years, women 25%) in the control arm of our SUPPORT trial, in which we examined additive impact of olmesartan in hypertensive patients with symptomatic CHF treated with β-blockers and/or angiotensin-converting enzyme inhibitors. We examined the association between glycaemic abnormality (assessed by 75 g of oral glucose tolerance test) and albuminuria for a composite outcome of all-cause death, myocardial infarction, stroke, and HF hospitalization. IGT patients (N = 113, mean 67.2 years) were older and more frequently treated with β-blockers compared with those with normal glucose regulation (N = 142, mean 64.0 years) and those with diabetes mellitus (N = 280, mean 65.7 years). Multivariable Cox proportional hazard models revealed that, as compared with normal glucose regulation (NGR), IGT was associated with increased risk of the outcome when complicated by albuminuria [hazard ratio (HR) 2.25; 95% confidence interval (CI) 1.14-4.42; P = 0.019] but not when uncomplicated by albuminuria (HR 0.76; 95% CI 0.35-1.60, P = 0.47) (P for interaction = 0.041). This was also the case for diabetes mellitus and albuminuria (HR 2.06; 95% CI 1.17-3.61; P = 0.012). Among IGT patients without albuminuria, 21 (29%) developed albuminuria at 1-year visit, which was again associated with poor prognosis (HR 7.36; 95% CI 1.39-38.98, P = 0.019). CONCLUSIONS: These results indicate that IGT is associated with poor prognosis when complicated by albuminuria in CHF patients, demonstrating the importance of combined early stages of glucose intolerance and renal dysfunction in the management of CHF."}