Diabetes mellitus was independently associated with an 11% increased risk of overall mortality compared to no diabetes in patients hospitalized for acute heart failure (adjusted HR 1.11).
Cohort (n=5,394)
Yes
Does diabetes mellitus increase mortality in patients hospitalized for acute heart failure?
Diabetes mellitus is independently associated with increased long-term mortality in patients hospitalized for acute heart failure, particularly those with reduced ejection fraction, highlighting the importance of adequate glycemic control.
Effect estimate: HR 1.11 (95% CI 1.03-1.22)
p-value: p=0.013
BACKGROUND: Although more than one-third of the patients with acute heart failure (AHF) have diabetes mellitus (DM), it is unclear if DM has an adverse impact on clinical outcomes. This study compared the outcomes in patients hospitalized for AHF stratified by DM and left ventricular ejection fraction (LVEF). METHODS: The Korean Acute Heart Failure registry prospectively enrolled and followed 5625 patients from March 2011 to February 2019. The primary endpoints were in-hospital and overall all-cause mortality. We evaluated the impact of DM on these endpoints according to HF subtypes and glycemic control. RESULTS: During a median follow-up of 3.5 years, there were 235 (4.4%) in-hospital mortalities and 2500 (46.3%) overall mortalities. DM was significantly associated with increased overall mortality after adjusting for potential confounders (adjusted hazard ratio HR 1.11, 95% confidence interval CI 1.03-1.22). In the subgroup analysis, DM was associated with higher a risk of overall mortality in heart failure with reduced ejection fraction (HFrEF) only (adjusted HR 1.14, 95% CI 1.02-1.27). Inadequate glycemic control (HbA1c ≥ 7.0% within 1 year after discharge) was significantly associated with a higher risk of overall mortality compared with adequate glycemic control (HbA1c < 7.0%) (44.0% vs. 36.8%, log-rank p = 0.016). CONCLUSIONS: DM is associated with a higher risk of overall mortality in AHF, especially HFrEF. Well-controlled diabetes (HbA1c < 7.0%) is associated with a lower risk of overall mortality compared to uncontrolled diabetes. Trial registration ClinicalTrial.gov, NCT01389843. Registered July 6, 2011. https://clinicaltrials.gov/ct2/show/NCT01389843.
Kong et al. (Sat,) conducted a cohort in Acute heart failure (n=5,394). Diabetes mellitus vs. No diabetes mellitus was evaluated on Overall all-cause mortality (HR 1.11, 95% CI 1.03-1.22, p=0.013). Diabetes mellitus was independently associated with an 11% increased risk of overall mortality compared to no diabetes in patients hospitalized for acute heart failure (adjusted HR 1.11).