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Impact of new-onset diabetes mellitus and glycemic control on the prognosis of heart failure patients: a propensity-matched study in the community

, : Impact of new-onset diabetes mellitus and glycemic control on the prognosis of heart failure patients: a propensity-matched study in the community. International Journal of Cardiology 167(4): 1206-1216

To assess the incidence of type 2 diabetes mellitus (DM) in patients with heart failure (HF), and to evaluate the effect of new-onset DM and glycemic control on the prognosis of HF patients treated with a contemporary medical regimen. Prospective study of 5314 HF patients and previously unknown DM during 9years. Their mean age was 71.8A 7.9years, 53.0% were women, and 50.2% had non-systolic HF. During a median follow-up of 56.9A 18.2months, 68.9% of the patients died, 88.6% were hospitalized for HF, and 1519 (27.3%) developed new-onset DM. We propensity-matched those 1519 HF patients with DM, with 1519 HF patients non-diagnosed with DM. The age- and sex-adjusted incidence (per 100HFpatients/years) of DM in HF patients was 3.20, higher in women and in patients with non-systolic HF (p <0.01). Patients with HF and DM and those with a mean HbA1c>7.0% presented an increased mortality (HR of death [CI 95%]: 2.44 [1.68a 3.19] and, HR: 2.56 [1.77a 3.35], respectively), mainly due to an increased cardiovascular mortality (HRa 2.40 [1.46a 3.34]) (P <0.001). The rate of hospitalization, of 30-day readmissions, and the number of visits were higher among HF patients with DM or with HbA1c>7.0% (p <0.001). These relationships of DM and its poor metabolic control with prognosis were maintained, independently of the gender, the type of HF (systolic or, non-systolic), the comorbidities, and the medication used (P <0.01). New-onset diabetes mellitus and its poor metabolic control (HbA1c>7.0%) are associated with a increased mortality and morbidity of patients with heart failure.


PMID: 22560913

DOI: 10.1016/j.ijcard.2012.03.134

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