Patients with advanced CHF (i.e. those in New York Heart Association (NYHA) classes III and IV) appear to have a greater risk of developing diabetes than those with milder symptoms (i.e. those in NYHA class II). In a subgroup analysis of 630 patients with CHF secondary to CHD in the Bezafibrate Infarction Prevention (BIP) study, NYHA class III was an independent risk factor for diabetes while NYHA class II was not (Tenenbaum etal., 2003). In an Italian longitudinal study of 1339 elderly patients, CHF was an independent predictor of diabetes (Amato etal., 1997). The association of CHF with diabetes was greater in patients in NYHA III and IV than those in NYHA I and II.
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