Patients with acute heart failure and diabetes had a significantly worse 10-year composite outcome compared to those without diabetes (87% vs. 76%; HR 1.17; 95% CI 1.02-1.33).
Cohort (n=1,810)
Does the presence of diabetes worsen the 10-year prognosis in patients admitted with acute heart failure?
While patients with acute heart failure and diabetes have worse long-term outcomes than those without diabetes, prognosis has improved comparably for both groups over the last three decades.
Effect estimate: HR 1.17 (95% CI 1.02-1.33)
Absolute Event Rate: 87% vs 76%
OBJECTIVE: We studied differences in long-term (i.e., 10 year) prognosis among patients with acute heart failure (HF) with and without diabetes over the last three decades. In addition, we investigated whether the degree of prognostic improvement in that period was comparable between patients with and without diabetes. RESEARCH DESIGN AND METHODS: This prospective registry included all consecutive patients aged 18 years and older admitted to the Intensive Coronary Care Unit with acute HF in the period of 1985-2008. A total of 1,810 patients were included; 384 patients (21%) had diabetes. The outcome measure was the composite of all-cause mortality, heart transplantation, and left ventricular assist device implantation after 10-year follow-up. RESULTS: The 10-year outcome in patients with diabetes was significantly worse than in those without diabetes (87% vs. 76%; adjusted hazard ratio HR 1.17 95% CI 1.02-1.33). Patients admitted in the last decade had a significantly lower 10-year event rate than patients admitted in the first two decades, both among patients without diabetes (adjusted HR 0.86 95% CI 0.75-0.99) and patients with diabetes (adjusted HR 0.80 95% CI 0.63-1.00). CONCLUSIONS: The long-term outcome of patients with diabetes is worse than that of patients without diabetes. However, the long-term prognosis improved over time in both groups. Importantly, this improvement in long-term prognosis was comparable in patients with and without diabetes. Despite these promising results, more awareness for diabetes in patients with acute HF is necessary and there is still need for optimal treatment of diabetes in acute HF.
Berge et al. (Thu,) conducted a cohort in Acute heart failure with and without diabetes (n=1,810). Diabetes vs. Without diabetes was evaluated on Composite of all-cause mortality, heart transplantation, and left ventricular assist device implantation (HR 1.17, 95% CI 1.02-1.33). Patients with acute heart failure and diabetes had a significantly worse 10-year composite outcome compared to those without diabetes (87% vs. 76%; HR 1.17; 95% CI 1.02-1.33).