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Heart failure due to systolic dysfunction and mortality in diabetes: pooled analysis of 39,505 subjects

Masoor Kamalesh1, Ton J Cleophas

  • 1Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana, USA. mkamales@iupui.edu

Journal of Cardiac Failure
|April 29, 2009
PubMed

Insights

Diabetic patients with congestive heart failure (CHF) face significantly higher risks of death and hospitalization. This meta-analysis found a 28% increased mortality and 36% increased hospitalization risk for diabetics with CHF.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Congestive heart failure (CHF) management has improved, but diabetes may increase mortality risk in CHF patients.
  • Existing data suggests a potential disparity in outcomes for CHF patients with diabetes.

Purpose of the Study:

  • To conduct a meta-analysis to determine the aggregate risk of mortality and hospitalization in CHF patients with diabetes.
  • To quantify the increased risk associated with diabetes in systolic dysfunction and CHF.

Main Methods:

  • A systematic search of MEDLINE and Cochrane databases identified 17 eligible trials (n=39,505) published since 2001.
  • Studies included had a minimum follow-up of 6 months and excluded small sample sizes (n < 200).
  • Data on mortality and CHF hospitalization were extracted for meta-analysis, assessing risk, heterogeneity, and publication bias.

Main Results:

  • Diabetic CHF patients had a significantly higher relative risk of mortality by 28% (95% CI 1.22-1.34).
  • Pooled relative risk for CHF hospitalization was also significantly higher for diabetics by 36% (95% CI 1.26-1.48).
  • Heterogeneity was noted, primarily from observational studies, with no significant publication bias.

Conclusions:

  • Diabetic individuals with CHF face a substantially elevated risk of mortality and recurrent hospitalizations.
  • Future research should prioritize interventions to improve survival rates in this high-risk population.
Abstract

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