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Title: Diabetes and heart failure
Author: MacDonald, Michael Ross
ISNI:       0000 0004 2709 7658
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2011
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The aim of this thesis was to explore the relationship between diabetes and heart failure, particularly focusing on epidemiology, aetiology and treatment. I was granted access to a number of databases that included patients with both diabetes and heart failure. Chapter one is a systematic review of the literature and each subsequent chapter describes an analysis of the individual patient cohorts. Chapters two to five examine the association of diabetes with both short and long-term outcomes in populations with different types of heart failure: out-patients with chronic heart failure; acute heart failure; incident heart failure; and patients at high risk of heart failure following myocardial infarction. In the short-term, diabetes is not associated with increased mortality. It is, however, associated with an increased risk of heart failure. In the long-term, diabetes is associated with an increased risk of death and heart failure. The association of diabetes with prognosis is independent of age and co-morbidity. Chapter six examines the risk of unrecognised myocardial infarction in a diabetic cohort from the RECORD study. Unrecognised myocardial infarction may be an aetiological factor in the development of heart failure in diabetes. Chapter 7 is a case-control study of the GPRD cohort that examines the use of anti-diabetic treatments in patients with heart failure. Of all the treatments metformin was the only treatment associated with improved mortality. Diabetes and heart failure are so common and carry such a poor prognosis, when present together, that even a small advance in their treatment could result in considerable improvement in outcomes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available