@article{f0addbae29c94c2b86c13449b0039f4f,
title = "Management of patients with diabetes and heart failure with reduced ejection fraction: An international comparison",
abstract = "Aims: To compare the management of patients with diabetes and heart failure with reduced ejection fraction (HFrEF) in the United States and Asia to understand variations in treatment patterns across different healthcare systems. Materials and methods: Our cohort included patients with diabetes and HFrEF (ejection fraction <40%) from a US-based registry of adults with diabetes (2013-2016, electronic health records) and a multi-national Asian registry of adults with heart failure (2010-2016, prospective registry). Asian countries were categorized as high income (HI) or low income (LI), according to the United Nations classification. Rates of use of guideline-directed medical therapies (determined through review of active medication lists) were compared across regions. Results: Patients with diabetes and HFrEF in the United States (n = 28 877) were older, had higher body mass indices, and were more likely to have coronary disease than those in Asia (n = 2235). Compared with US patients, the use of guideline-directed medical therapy for HFrEF was lower in patients in LI Asian countries (angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers: patients in the United States, 77% vs. patients in HI Asian countries, 76% vs patients in LI Asian countries, 69%; β-blockers: patients in the United States, 91% vs. patients in HI Asian countries, 87% vs. patients in LI Asian countries, 69%; P < 0.001 for both). Insulin was used more commonly in the United States (44% vs. 24% vs. 25%, respectively; P < 0.001), whereas sulphonylureas were more often prescribed in Asian countries (42% vs. 52% vs. 54%; respectively, P < 0.001). Thiazolidinediones were prescribed in 6% of US patients compared with <1% of patients in Asia. The use of newer diabetes medications was <5% in all. Conclusion: In both the United States and Asia, opportunities for improvement in the use of evidence-based therapies exist for patients with both diabetes and HFrEF. Effective tools to guide medication choices for these complex, high-risk patients could have substantial impact on quality and outcomes.",
keywords = "diabetes mellitus, heart failure, quality of care, registries, systolic dysfunction",
author = "Arnold, {Suzanne V.} and Jonathan Yap and Lam, {Carolyn S.P.} and Fengming Tang and Tay, {Wan T.} and Teng, {Tiew H.K.} and McGuire, {Darren K} and Januzzi, {James L.} and Fonarow, {Gregg C.} and Masoudi, {Frederick A.} and Mikhail Kosiborod",
note = "Funding Information: information The Diabetes Collaborative Registry is funded by AstraZeneca (founding sponsor) and Boehringer Ingelheim. Corporate sponsors had no role in data analysis or interpretation, manuscript development, or in publication review or approval for this study. The ASIANHF study is funded by the Investigator-Sponsored Research Program of Boston Scientific, via a grant for investigator-initiated studies awarded to the Cardiovascular Research Institute in Singapore. Recruitment of patients in Singapore is supported by the Singapore Heart Failure Outcomes and Phenotypes study funded by the National Medical Research Council of Singapore. Funding Information: The Diabetes Collaborative Registry is funded by AstraZeneca (founding sponsor) and Boehringer Ingelheim. Corporate sponsors had no role in data analysis or interpretation, manuscript development, or in publication review or approval for this study. The ASIAN-HF study is funded by the Investigator-Sponsored Research Program of Boston Scientific, via a grant for investigator-initiated studies awarded to the Cardiovascular Research Institute in Singapore. Recruitment of patients in Singapore is supported by the Singapore Heart Failure Outcomes and Phenotypes study funded by the National Medical Research Council of Singapore. Funding Information: C.S.L. is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore, has received research support from Boston Scientific, Bayer, Thermofisher, Medtronic and Vifor Pharma, and has consulted for Bayer, Novartis, Takeda, Merck, Astra Zeneca, Janssen Research & Development, LLC, Menarini, Boehringer Ingelheim and Abbott Diagnostics. D.K.M. has received honoraria for trial leadership from Boehringer Ingelheim, Janssen Research and Development LLC, Merck Sharp and Dohme Corp, Lilly USA, Novo Nordisk, GlaxoSmithKline, Takeda Pharmaceuticals North America, AstraZeneca and Lexicon, and honoraria for consultancy from Janssen Research and Development LLC, Sanofi Aventis Groupe, Merck Sharp and Dohme Corp., Novo Nordisk and Regeneron. M.K. has received research grants from AstraZeneca, Boehringer Ingelheim, other research support from AstraZeneca, and consulting honoraria from AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Sanofi, Amgen, GSK, Merck (Diabetes), Eisai, Intarcia, Novartis, Glytec and ZS Pharma. G.C.F. has acted as a consultant for Amgen, Bayer, Janssen and Novartis. The remaining authors report no disclosures relevant to the present manuscript. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons Ltd",
year = "2019",
month = feb,
doi = "10.1111/dom.13511",
language = "English (US)",
volume = "21",
pages = "261--266",
journal = "Diabetes, Obesity and Metabolism",
issn = "1462-8902",
publisher = "Wiley-Blackwell",
number = "2",
}