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Diabetes Mellitus in Advanced Heart Failure
Shannon M Dunlay1, Jill M Killian2, Rozalina G Mccoy3
1Department of Cardiovascular Medicine; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.
Journal of Cardiac Failure
|October 14, 2021
Summary
In advanced heart failure (HF), diabetes is common but does not increase mortality risk. However, multiple diabetes complications significantly elevate mortality risk in advanced HF patients.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Diabetes mellitus is linked to higher mortality in less severe heart failure (HF).
- The impact of diabetes and its complications on mortality in advanced (stage D) HF remains unclear.
Purpose of the Study:
- To investigate the prevalence of diabetes and its complications in advanced HF.
- To determine the association between diabetes, its complications, and mortality risk in advanced HF patients.
Main Methods:
- Retrospective cohort study of advanced HF patients in Olmsted County, Minnesota (2007-2017).
- Diabetes identified using Healthcare Effectiveness Data and Information Set criteria.
- Diabetes Complications Severity Index used to assess complication burden.
Main Results:
- 36.1% of 936 advanced HF patients had diabetes.
- Diabetes status or glycated hemoglobin levels did not significantly impact mortality.
- Increased mortality risk observed in patients with 5-7 diabetes complications (aHR 1.49).
Conclusions:
- Diabetes is prevalent in advanced HF but not independently associated with increased mortality.
- The number of diabetes complications is a significant predictor of mortality in advanced HF.
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