{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:14:42Z","timestamp":1773209682033,"version":"3.50.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":1987,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:00:00Z","timestamp":1594425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Cardiac resynchronization therapy (CRT) has become an important therapy in patients with heart failure with reduced left ventricular ejection fraction (LVEF). The effect of diabetes on long-term outcome in these patients is controversial. We assessed the effect of diabetes on long-term outcome in CRT patients and investigated the role of diabetes in ischaemic and non-ischaemic cardiomyopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>All patients undergoing CRT implantation at our institution between November 2000 and January 2015 were enrolled. The study endpoints were (i) a composite of ventricular assist device (VAD) implantation, heart transplantation, or all-cause mortality; and (ii) reverse remodelling (improvement of LVEF \u2265 10% or reduction of left ventricular end-systolic volume \u2265 15%). Median follow-up of the 418 patients (age 64.6 \u00b1 11.6 years, 22.5% female, 25.1% diabetes) was 4.8 years [inter-quartile range: 2.8;7.4]. Diabetic patients had an increased risk to reach the composite endpoint [adjusted hazard ratio (aHR) 1.48 [95% CI 1.12\u20132.16], P = 0.041]. Other factors associated with an increased risk to reach the composite endpoint were a lower body mass index or baseline LVEF (aHR 0.95 [0.91; 0.98] and 0.97 [0.95; 0.99], P &amp;lt; 0.01 each), and a higher New York Heart Association functional class or creatinine level (aHR 2.14 [1.38; 3.30] and 1.04 [1.01; 1.05], P &amp;lt; 0.05 each). Early response to CRT, defined as LVEF improvement \u2265 10%, was associated with a lower risk to reach the composite endpoint (aHR 0.60 [0.40; 0.89], P = 0.011). Reverse remodelling did not differ between diabetic and non-diabetic patients with respect to LVEF improvement \u2265 10% (aHR 0.60 [0.32; 1.14], P = 0.118). However, diabetes was associated with decreased reverse remodelling with respect to a reduction of left ventricular end-systolic volume \u2265 15% (aHR 0.45 [0.21; 0.97], P = 0.043). In patients with ischaemic cardiomyopathy, survival rates were not significantly different between diabetic and non-diabetic patients (HR 1.28 [0.83\u20131.97], P = 0.101), whereas in patients with non-ischaemic cardiomyopathy, diabetic patients had a higher risk of reaching the composite endpoint (HR 1.65 [1.06\u20132.58], P = 0.027). The latter effect was dependent on other risk factors (aHR 1.47 [0.83\u20132.61], P = 0.451). The risk of insulin-dependent patients was not significantly higher than in patients under oral antidiabetic drugs (HR 1.55 [95% CI 0.92\u20132.61], P = 0.102).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long-term follow-up revealed diabetes mellitus as independent risk factor for all-cause mortality, heart transplantation, or VAD in heart failure patients undergoing CRT. The detrimental effect of diabetes appeared to weigh heavier in patients with non-ischaemic compared with ischaemic cardiomyopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12876","type":"journal-article","created":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T17:36:52Z","timestamp":1594489012000},"page":"2773-2783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Differential Effect of Cardiac Resynchronization Therapy in Patients with Diabetes Mellitus: A Long-Term Retrospective Cohort Study"],"prefix":"10.1093","volume":"7","author":[{"given":"Peter C.","family":"Kahr","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sander","family":"Trenson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]},{"name":"Cardiovascular Sciences, University Hospital Leuven , Leuven ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00ebl","family":"Kuster","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]},{"name":"Department of Medicine, GZO Zurich Regional Health Center , Wetzikon ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Tonko","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Hofer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devdas T.","family":"Inderbitzin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Heart Center Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Breitenstein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ardan M.","family":"Saguner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas J.","family":"Flammer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Steffel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Winnik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich , Raemistr. 100, Zurich, 8091 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,7,11]]},"reference":[{"key":"2026012114052832200_ehf212876-bib-0001","doi-asserted-by":"crossref","first-page":"3547","DOI":"10.1093\/eurheartj\/eht290","article-title":"An individual patient meta-analysis of five randomized trials assessing the effects of cardiac resynchronization therapy on morbidity and mortality in patients with symptomatic heart failure","volume":"34","author":"Cleland","year":"2013","journal-title":"Eur Heart 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