Age affects the prognostic impact of diabetes in chronic heart failure

Area of Science:

• Cardiology
• Geriatrics
• Endocrinology

Background:

• Increasing age is a known factor influencing prognosis in chronic heart failure (HF).
• Diabetes mellitus frequently complicates the course of HF and is associated with a poorer prognosis.
• The differential impact of diabetes on HF mortality based on patient age has not been extensively studied.

Purpose of the Study:

• To evaluate the impact of diabetes on the all-cause mortality of patients with chronic heart failure (HF).
• To investigate whether the prognostic significance of diabetes in HF differs between younger and older adult populations.

Main Methods:

• A prospective cohort study of 283 ambulatory patients with chronic HF on optimized therapy was conducted.
• Patients were followed for up to 5 years, with all-cause mortality as the primary endpoint.
• Cox regression analysis, stratified by age (cutoff 75 years), was used to assess mortality predictors, with formal testing for interaction between diabetes and age.

Main Results:

• In patients younger than 75 years, diabetes was associated with a multivariate adjusted 1.98-fold increased risk of 5-year mortality (95% CI 1.13-3.46).
• In patients aged 75 years and older, no significant association between diabetes and 5-year mortality was found.
• A significant interaction between age and the prognostic impact of diabetes on mortality was observed (p=0.04).

Conclusions:

• The prognostic effect of diabetes on mortality in chronic HF patients is age-dependent.
• Diabetes confers a significantly higher mortality risk in HF patients under 75 years old.
• In contrast, diabetes does not appear to impact mortality risk in HF patients aged 75 years or older.