Type 2 Diabetes Associated With Poorer Outcomes in Heart Failure
THURSDAY, Aug. 22, 2019 -- For patients with heart failure, type 2 diabetes is associated with structural changes in the heart, poorer quality of life, and increased mortality, according to a study published online Aug. 21 in the Journal of the American Heart Association.
Jonathan Yap, M.B.B.S., M.P.H., from the National Heart Centre Singapore, and colleagues compared echocardiographic parameters, quality of life, and outcomes for heart failure patients with and without type 2 diabetes mellitus and among community-based controls without heart failure.
The prevalence of type 2 diabetes mellitus was 40.2 and 45.0 percent among 5,028 patients with heart failure with reduced ejection fraction (HFrEF) and 1,139 patients with heart failure with preserved ejection fraction (HFpEF), respectively. The researchers found that diabetes mellitus correlated with smaller indexed left ventricular diastolic volumes and higher mitral E/e' ratio in both the HFrEF and HFpEF cohorts. A predominance of eccentric hypertrophy and concentric hypertrophy was seen in the HFrEF and HFpEF cohorts, respectively. Lower Kansas City Cardiomyopathy Questionnaire scores (assessing quality of life) were seen for patients with diabetes mellitus in the HFrEF and HFpEF cohorts, with more prominent differences in those with HFpEF. Patients with diabetes mellitus had more heart failure rehospitalizations (adjusted hazard ratio, 1.27) and higher one-year rates of the composite of all-cause mortality/heart failure hospitalization (adjusted hazard ratio, 1.22) in both the HFrEF and HFpEF cohorts.
"Our findings emphasize the need for preventative public health measures," Yap said in a statement. "For heart failure patients who have diabetes, physicians should closely monitor and optimize their management."
Several authors disclosed financial ties to the pharmaceutical industry.
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Posted: August 2019