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Diabetes Mellitus and Long-Term Risk for Heart Failure After Coronary Revascularization

Yasuaki Takeji1, Hiroki Shiomi1, Takeshi Morimoto2

  • 1Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 31, 2020
PubMed

Insights

Diabetes mellitus (DM) significantly increases heart failure (HF) risk after coronary revascularization. Insulin treatment in DM patients did not further elevate this risk compared to non-insulin-treated DM patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • The long-term impact of diabetes mellitus (DM) on heart failure (HF) risk post-coronary revascularization requires further investigation.
  • Understanding this relationship is crucial for managing cardiovascular outcomes in diabetic patients.

Purpose of the Study:

  • To evaluate the effect of diabetes mellitus (DM) status on the long-term risk of heart failure (HF) hospitalization in patients undergoing coronary revascularization.
  • To compare the risk between insulin-treated DM (ITDM) and non-insulin-treated DM (NITDM) patients.

Main Methods:

  • A cohort of 15,231 patients from the CREDO-Kyoto Registry Cohort-2 who underwent coronary revascularization were analyzed.
  • Patients were categorized into DM (n=5,999) and Non-DM (n=9,232) groups. DM patients were further divided into ITDM (n=1,353) and NITDM (n=4,646) groups.
  • The primary outcome was HF hospitalization, assessed over a 5-year period using survival analysis and adjusted for confounders.

Main Results:

  • The 5-year cumulative incidence of HF hospitalization was significantly higher in DM patients (11.0%) compared to Non-DM patients (6.6%) (P<0.0001).
  • HF hospitalization rates were also higher in ITDM patients (14.6%) versus NITDM patients (10.0%) (P<0.0001).
  • After adjustment, DM remained a significant risk factor for HF hospitalization (HR 1.47, P<0.0001), but the difference between ITDM and NITDM was not significant (HR 1.17, P=0.12).

Conclusions:

  • Diabetes mellitus significantly increases the long-term risk of heart failure hospitalization following coronary revascularization.
  • The increased risk associated with DM persists regardless of the revascularization strategy used.
  • No significant difference in HF hospitalization risk was observed between insulin-treated and non-insulin-treated DM patients.
Abstract

Keywords:
Coronary artery diseaseDiabetes mellitusHeart failure

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