Justin B Echouffo-Tcheugui1, Haolin Xu2, Adam D DeVore2, Phillip J Schulte3, Javed Butler4, Clyde W Yancy5, Deepak L Bhatt6, Adrian F Hernandez2, Paul A Heidenreich7, Gregg C Fonarow8. 1. Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Electronic address: jechouffotcheugui@partners.org. 2. Duke Clinical Research Institute, Durham, NC. 3. Department of Health Sciences Research, Mayo Clinic, Rochester, MN. 4. Cardiology Division, Stony Brook University, Stony Brook, NY. 5. Cardiology Division, Northwestern Feinberg School of Medicine, Chicago, IL. 6. Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. 7. Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, and Stanford University, Stanford, CA. 8. Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, CA.
Abstract
BACKGROUND: The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden. METHODS: Using data from the Get With the Guidelines-Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40%≤EF <50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015. Logistic regression was used to assess whether in-hospital outcomes and HF quality of care were related to trends. RESULTS: Among 364,480 HF hospitalizations, 160,171 had diabetes (44.0% overall, 41.8% in HFrEF, 46.7% in HFbEF, 45.5% in HFpEF). There was a temporal increase in diabetes frequency in HF patients (43.2%-45.8%; Ptrend <.0001), including among those with HFrEF (42.0%-43.6%; Ptrend <.0001), HFbEF (46.0%-49.2%; Ptrend <.0001), or HFpEF (43.6%-46.8%, Ptrend <.0001). Diabetic patients had a longer hospital stay (adjusted odds ratio 1.14, 95% CI 1.12-1.16), but lower in-hospital mortality (adjusted odds ratio 0.93 [0.89-0.97]) compared with those without diabetes, with limited differences in quality measures. Temporal trends in diabetes were not associated with in-hospital mortality or length of stay. There were no temporal interactions of most HF quality measures with diabetes status. CONCLUSIONS: Approximately 44% of hospitalized HF patients have diabetes, and this proportion has been increasing over the past 10years, particularly among those patients with new-onset HFpEF. Copyright Â
BACKGROUND: The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden. METHODS: Using data from the Get With the Guidelines-Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40%≤EF <50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015. Logistic regression was used to assess whether in-hospital outcomes and HF quality of care were related to trends. RESULTS: Among 364,480 HF hospitalizations, 160,171 had diabetes (44.0% overall, 41.8% in HFrEF, 46.7% in HFbEF, 45.5% in HFpEF). There was a temporal increase in diabetes frequency in HF patients (43.2%-45.8%; Ptrend <.0001), including among those with HFrEF (42.0%-43.6%; Ptrend <.0001), HFbEF (46.0%-49.2%; Ptrend <.0001), or HFpEF (43.6%-46.8%, Ptrend <.0001). Diabeticpatients had a longer hospital stay (adjusted odds ratio 1.14, 95% CI 1.12-1.16), but lower in-hospital mortality (adjusted odds ratio 0.93 [0.89-0.97]) compared with those without diabetes, with limited differences in quality measures. Temporal trends in diabetes were not associated with in-hospital mortality or length of stay. There were no temporal interactions of most HF quality measures with diabetes status. CONCLUSIONS: Approximately 44% of hospitalized HF patients have diabetes, and this proportion has been increasing over the past 10years, particularly among those patients with new-onset HFpEF. Copyright Â
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