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Diabetes increases all-cause mortality risk in chronic heart failure
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Adults with chronic heart failure and diabetes have higher risks for all-cause death, cardiovascular death and hospitalization for worsening heart failure compared with adults with chronic heart failure without diabetes, according to published findings.
“Heart failure and diabetes are two chronic and progressive clinical conditions that share the dismal privilege of becoming increasingly common worldwide,” Marco Dauriz, MD, PhD, assistant professor in the division of endocrinology, diabetes and metabolism, department of general medicine at the University of Verona School of Medicine and Hospital Trust of Verona in Italy, told Endocrine Today. “In this work, we have shown that the prevalence of diabetes is disproportionately high in patients with chronic heart failure, and that diabetes per se carries a considerably increased risk at 1 year of all-cause death, [CV] death and hospitalization for worsening heart failure, independently of multiple cardiometabolic risk factors. Notably, among heart failure patients with available HbA1c measurements, a poorer glycemic control at baseline showed a significant and independent association with an increased risk of 1-year adverse survival outcomes.”
Dauriz and colleagues evaluated data from the European Association of Cardiology and Heart Failure Association Long-Term Registry on 9,428 outpatients (71.5% men) with chronic heart failure to determine the effect of diabetes on 1-year adverse outcomes.
Overall, 36.5% of participants had diabetes. During 1 year of follow-up, 8% of participants died; 394 deaths were due to CVD causes, and 1,030 first hospitalizations were for worsening heart failure.
Compared with participants without diabetes, participants with diabetes had higher rates of all-cause death (9.4% vs. 7.2%), CVD death (4.8% vs. 3.8%) and first hospitalization for worsening heart failure (13.8% vs. 9.3%; P = .017 to < .001 for differences between the groups).
The risks for all-cause death (adjusted HR = 1.28; 95% CI, 1.07-1.54) and CVD death (adjusted HR = 1.28; 95% CI, 0.99-1.66) were nearly 30% higher in participants with diabetes compared with those without the disease, and the risk for first hospitalization for worsening heart failure was also higher (adjusted HR = 1.37; 95% CI, 1.17-1.6).
“Our data advocate an increased awareness by the clinical cardiologist, endocrinology and practicing physician on the adverse prognostic significance of diabetes and glycemic control in patients with chronic heart failure and point to the need for therapies that improve the survival outcomes in this high-risk population,” Dauriz told Endocrine Today. “It is expected that the early identification of diabetes in patients with chronic heart failure would stem from a multidisciplinary approach aimed at delivering the most appropriate pharmacologic treatment in light of a timely recognition or multimorbidity, an earlier referral to the reference specialist, and close follow-up schedules.” – by Amber Cox
For more information:
Marco Dauriz, MD, PhD, can be reached at University of Verona School of Medicine, Ospedale Civile Maggiore, P.le Stefani, 1 – Pad. 22, 3716 Verona, Italy; email: marco.dauriz@univr.it.
Disclosure: Dauriz reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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