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Insulin-treated diabetes is associated with a marked increase in mortality in patients with advanced heart failure

Stephanie Smooke1, Tamara B Horwich, Gregg C Fonarow

  • 1Ahmanson-UCLA Cardiomyopathy Center, Los Angeles, Calif 90095-1679, USA.

American Heart Journal
|January 22, 2005
PubMed

Insights

Insulin-treated diabetes significantly worsens survival in advanced heart failure (HF) patients. Non-insulin-treated diabetes did not impact HF prognosis, highlighting the need for further research into insulin

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Diabetes mellitus is a known risk factor for heart dysfunction.
  • The prognostic impact of diabetes and insulin use in advanced heart failure (HF) remains understudied.

Purpose of the Study:

  • To investigate the effect of diabetes and insulin treatment on survival in patients with advanced HF.
  • To stratify HF patients based on diabetes status and insulin use to assess differential survival outcomes.

Main Methods:

  • A cohort of 554 advanced systolic HF patients was analyzed.
  • Patients were categorized into three groups: non-diabetic, non-insulin-treated diabetic, and insulin-treated diabetic.
  • Survival rates and predictors of mortality were evaluated using Cox multivariate analysis.

Main Results:

  • Insulin-treated diabetic patients (7.8%) had significantly lower 1-year survival (62.1%) compared to non-diabetic (89.7%) and non-insulin-treated diabetic patients (85.8%).
  • Insulin-treated diabetes was an independent predictor of mortality (HR 4.30), while non-insulin-treated diabetes was not (HR 0.95).
  • These findings were consistent across relevant subgroups.

Conclusions:

  • Insulin-treated diabetes is associated with a substantially worse prognosis in advanced HF.
  • Further research is needed to elucidate the mechanisms linking insulin treatment and mortality in HF patients.
Abstract

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