{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:06:03Z","timestamp":1789535163118,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100019189","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019189","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["523-2014-2336"],"award-info":[{"award-number":["523-2014-2336"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Swedish Heart Lung Foundation","doi-asserted-by":"publisher","award":["20190310"],"award-info":[{"award-number":["20190310"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011727","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["20190525"],"award-info":[{"award-number":["20190525"]}],"id":[{"id":"10.13039\/501100011727","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The interactions between heart failure (HF), chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and relative drug use remain poorly studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients enrolled in the Swedish HF registry 2017\u20132023 were divided according to CKD and T2DM. HF medication use and all-cause death, cardiovascular death, first HF hospitalization (HHF), their composite, and end-stage renal disease (ESRD) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 54 341 patients (34% females, mean age 73 years), 51% had no CKD\/no T2DM, 24% CKD only, 14% T2DM only, and 11% both CKD\/T2DM. CKD only and CKD\/T2DM prevalences were higher in HF with preserved ejection fraction (HFpEF; 29% and 15%, respectively) than with mildly reduced EF (HFmrEF; 23% and 11%) and reduced EF (HFrEF 22% and 10%). HF medication use, especially of mineralocorticoid receptor antagonists, was generally lower in groups with CKD. Event rates for all outcomes were progressively higher going from no CKD\/no T2DM, T2DM only, CKD only, and both CKD\/T2DM in all EF categories. Independent risks of mortality and HF outcomes were significantly increased in the presence of CKD\/T2DM, whereas for ESRD, T2DM alone did not significantly increase risk, CKD alone increased it threefold, and both CKD and T2DM increased it six-fold. CKD added more to the risk of events in HFrEF than in HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CKD was more common in HFpEF and a strong independent risk factor for all outcomes. T2DM was a moderate independent risk factor for all outcomes. These findings inform drug implementation and future aldosterone-targeting drug trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag249","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:29:57Z","timestamp":1786706997000},"source":"Crossref","is-referenced-by-count":0,"title":["Type 2 diabetes and chronic kidney disease combinations in heart failure across the ejection fraction spectrum: clinical associations, medication use, and cause-specific outcomes: a contemporary, real-world analysis of the Swedish Heart Failure Registry"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0318-7435","authenticated-orcid":false,"given":"Giulia","family":"Ferrannini","sequence":"first","affiliation":[{"name":"Cardiology Unit, Department of Medicine, Karolinska Institutet , Eugeniav\u00e4gen 27, Stockholm 17164 ,","place":["Sweden"]},{"name":"Internal Medicine Unit, S\u00f6dert\u00e4lje Hospital , 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