Insulin resistance and risk for incident heart failure.

The association between type 2 diabetes mellitus (DM) and heart failure (HF) has been well-described for at least 4 decades (1), with DM increasing the risk of HF by 2to 6-fold (2). Based on these observations, DM was included as 1 of the criteria for the diagnosis of Stage A HF in the revised American College of Cardiology/American Heart Association (AHA) HF classification scheme introduced in 2001 (3), identifying patients at particularly high risk of developing HF. The classification was modified in 2005 to also include the metabolic syndrome and obesity (4), underscoring the association between insulin-resistant conditions and HF risk.