Francisco Javier Carrasco-Sánchez1, Ricardo Gomez-Huelgas2, Francesc Formiga3, Alicia Conde-Martel4, Joan Carles Trullàs5, Paulo Bettencourt6, José Carlos Arévalo-Lorido7, Manuel Montero Pérez-Barquero8. 1. Internal Medicine Department, Hospital Juan Ramón Jiménez, Huelva, Spain. Electronic address: fjcarrascos@telefonica.net. 2. Internal Medicine Department, Hospital Regional Universitario, Málaga, Spain. 3. Internal Medicine Department, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 4. Internal Medicine Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain. 5. Internal Medicine Department, Hospital Sant Jaume, Olot, Girona, Spain. 6. Internal Medicine Department, Hospital de São João, Porto, Portugal. 7. Internal Medicine Department, Hospital Comarcal de Zafra, Badajoz, Spain. 8. Internal Medicine Department, IMBIC/Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain.
Abstract
AIMS: Heart failure (HF) and diabetes are common clinical conditions that may coexist. The main objective was to analyze the association of type-2 diabetes mellitus (T2DM) on prognosis in hospitalized patients with HF. METHODS: We evaluated the association between T2DM with all-cause mortality and readmissions in the Spanish National Registry on Heart Failure-"Registro Nacional de Insuficiencia Cardiaca" (RICA). This is a multi-center and prospective cohort study that includes patients admitted for decompensated HF from 2008 to 2011. Study endpoints were all-cause mortality and hospital readmission. We determined the adjusted hazard ratio (HR) by a multivariable Cox regression model. RESULTS: A total of 1082 patients (mean age 77.6±8.5) were included of whom 490 (45.3%) had diabetes and 592 patients (54.7%) had preserved left ventricular ejection fraction (LVEF). During one-year follow-up, 287 patients died (151 patients with diabetes) and 383 patients were readmitted (197 patients with diabetes). After adjusting for baseline characteristics T2DM was significantly associated with all-cause mortality (HR 1.54; 95%CI 1.20-1.97, p=0.001) and readmissions (HR 1.46; 95%CI 1.18-1.80, p<0.001). Age, dementia, peripheral vascular disease, NYHA class, renal insufficiency, hyponatremia and anemia were also independently associated with outcomes. There were no differences in mortality (p=0.415) and readmissions (p=0.514) according to preserved or reduced LVEF. CONCLUSION: T2DM is very common in patients hospitalized for HF. This condition is a strong and independent co-morbidity of all-cause mortality and readmission for both HF with preserved and reduced LVEF.
AIMS: Heart failure (HF) and diabetes are common clinical conditions that may coexist. The main objective was to analyze the association of type-2 diabetes mellitus (T2DM) on prognosis in hospitalized patients with HF. METHODS: We evaluated the association between T2DM with all-cause mortality and readmissions in the Spanish National Registry on Heart Failure-"Registro Nacional de Insuficiencia Cardiaca" (RICA). This is a multi-center and prospective cohort study that includes patients admitted for decompensated HF from 2008 to 2011. Study endpoints were all-cause mortality and hospital readmission. We determined the adjusted hazard ratio (HR) by a multivariable Cox regression model. RESULTS: A total of 1082 patients (mean age 77.6±8.5) were included of whom 490 (45.3%) had diabetes and 592 patients (54.7%) had preserved left ventricular ejection fraction (LVEF). During one-year follow-up, 287 patients died (151 patients with diabetes) and 383 patients were readmitted (197 patients with diabetes). After adjusting for baseline characteristics T2DM was significantly associated with all-cause mortality (HR 1.54; 95%CI 1.20-1.97, p=0.001) and readmissions (HR 1.46; 95%CI 1.18-1.80, p<0.001). Age, dementia, peripheral vascular disease, NYHA class, renal insufficiency, hyponatremia and anemia were also independently associated with outcomes. There were no differences in mortality (p=0.415) and readmissions (p=0.514) according to preserved or reduced LVEF. CONCLUSION: T2DM is very common in patients hospitalized for HF. This condition is a strong and independent co-morbidity of all-cause mortality and readmission for both HF with preserved and reduced LVEF.
Authors: Esteban Jodar; Sara Artola; Xavier Garcia-Moll; Estefany Uría; Noemí López-Martínez; Rosa Palomino; Virginia Martín Journal: BMJ Open Diabetes Res Care Date: 2020-07
Authors: K Khoo; J Lew; P Neef; L Kearney; L Churilov; R Robbins; A Tan; M Hachem; L Owen-Jones; Q Lam; G K Hart; A Wilson; P Sumithran; D Johnson; P M Srivastava; O Farouque; L M Burrell; J D Zajac; E I Ekinci Journal: Sci Rep Date: 2018-09-10 Impact factor: 4.379