Heart Failure and Type-2 DiabetesHeart failure (HF) is a life-threatening and prevalent disease that affects ~64 million people worldwide.1 One in five people in developed countries will develop the condition during the course of their life.2 It is commonly linked to those living with type-2 diabetes (T2D).3 People with T2D have a 2-to-5 times greater risk of HF plus increased risk of a heart attack or stroke.3

Overview

For people living with T2D, HF impacts their quality of life and overall health outcome.4 It is the leading cause of hospitalisation for those over the age of 65 and represents a significant clinical and economic burden.5 Here are some facts:

Heart failure is the most common first presentation of T2D-related cardiovascular (CV) event, more than heart attack (myocardial infarction) or stroke.14

Disease Burden

A healthy heart beats about 60 to 80 times per minute to pump blood. Blood passes through a valve before leaving each chamber of the heart. Ejection fraction (EF) is a measurement, expressed as a percentage, of how much blood the LV pumps out with each contraction.9

The Heart & Ejection Fraction

There are two main categories of HF related to EF: reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).10

Types of Heart Failure

HFrEF occurs when the LV muscle is not able to contract adequately and, therefore, expels less oxygen rich blood into the body. 10,11

HF remains as “malignant” as some of the most common cancers in both men (prostate and bladder cancers) and women (colorectal and breast cancers).15

Impact of Heart Failure

About AstraZeneca in Cardiovascular, Renal & Metabolism (CVRM)

HF is dramatically increasing with an aging population.13

Patients hospitalised with HF have the highest rates of early readmission following discharge.5

By 5 years after a T2D diagnosis, 68% (two-thirds) of patients have evidence of left ventricle (LV) dysfunction, often leading to HF.6,7

HF causes between ~10% to 28% of deaths in adults with cardiovascular disease, worldwide.8

HFpEF occurs when the LV does not relax normally, often due to stiffening of the heart. As a result, LV ejection fraction is preserved but the total volume of blood pumping through the heart is decreased – resulting in symptoms of pulmonary and systemic venous congestion.10,12

Cardiovascular, renal and metabolism together form one of AstraZeneca’s main therapy areas and a key growth driver for the Company. By

following the science to understand more clearly the underlying links between the heart, kidneys and pancreas, AstraZeneca is investing in

a portfolio of medicines to protect organs and improve outcomes by slowing disease progression, reducing risks and tackling co-morbidities.

Our ambition is to modify or halt the natural course of CVRM diseases and potentially regenerate organs and restore function, by continuing

to deliver transformative science that improves treatment practices and cardiovascular health for millions of patients worldwide.

References

1GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211-1259. 2European Society of Cardiology (ESC). "One in five people will develop heart failure." ScienceDaily. ScienceDaily, 5 May 2015. Available at: www.sciencedaily.com/releases/2015/05/150505111934.htm. Accessed June 2018. 3Rosano GM, Vitale C, Seferovic P. Heart Failure in Patients with Diabetes Mellitus. Card Fail Rev. 2017;3(1):52-55. 4Thomas MC. Type 2 Diabetes and Heart Failure: Challenges and Solutions. Curr Cardiol Rev. 2016;12(3):249-55. 5Azad, N., & Lemay, G. (2014). Management of chronic heart failure in the older population. Journal of geriatric cardiology: JGC, 11(4), 329-37. 6Faden G, et al. Diabetes Res Clin Res. 2013101;309-316. 7Seferović PM, Paulus WJ. EurHeart J. 2015;36:1718-27. 8R. Kaur A. Isherwood L. Ayodele M. Hughes; The global burden of chronic heart failure; European Heart Journal, Volume 38, Issue suppl_1, 1 August 2017. 9“Ejection Fraction.”Cleveland Clinic, my.clevelandclinic.org/health/articles/16950-ejection-fraction. [Last accessed: February 2019]. 10CVrg, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016 ;37 :2129 –2200. 11National Guideline Centre (UK). Chronic Heart Failure in Adults: Diagnosis and Management. London: National Institute for Health and Care Excellence (UK); 2018 Sep. (NICE Guideline, No. 106.) 13, Glossary. 12Borlaug, B. A., & Paulus, W. J. (2010). Heart failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment. European heart journal, 32(6), 670-9. 13Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017;3(1):7-11. 14Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular disease: a cohort study in 1.9 million people. Lancet Diabetes Endocrinol. 2015;3(2):105-113. 15Mamas MA. et al. Eur J of Heart Failure 2017.19:1095–1104.

Veeva ID: Z4-15513 | Date of preparation: March 2019 | Date of expiry: March 2020

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