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Updated: Jun 21, 2025
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Is Type 2 Diabetes Mellitus an Independent Risk Factor for Mortality in Hypertrophic Cardiomyopathy?
Said Hajouli1, Adam Belcher2, Frank Annie2
1Department of Cardiology, Charleston Area Medical Center, Charleston, WV, USA.
Insights
Type 2 diabetes mellitus (T2DM) significantly increases the risk of heart failure and mortality in hypertrophic cardiomyopathy (HCM) patients. This study highlights the need to consider T2DM as a critical risk factor in HCM management.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Mortality rates for hypertrophic cardiomyopathy (HCM) have declined, but risk factors for sudden cardiac death (SCD) require ongoing evaluation.
- Current guidelines for HCM risk stratification do not explicitly include Type 2 Diabetes Mellitus (T2DM) due to limited evidence.
- T2DM is a known risk factor for various cardiovascular diseases, prompting investigation into its role in HCM outcomes.
Purpose of the Study:
- To determine if T2DM is associated with an increased 5-year risk of adverse outcomes, including heart failure and all-cause mortality, in patients with HCM.
- To evaluate the impact of T2DM on the prognosis of individuals diagnosed with hypertrophic cardiomyopathy.
Main Methods:
- Retrospective cohort study utilizing the TriNetX database from January 1, 2018, to March 1, 2023.
- Inclusion of 80,502 individuals with HCM, divided into cohorts with (n=15,296) and without (n=58,573) T2DM.
- Survival and risk analyses were performed to assess 5-year all-cause mortality and new-onset heart failure incidence.
Main Results:
- HCM patients with T2DM exhibited a statistically significant increase in all-cause mortality compared to those without T2DM.
- A significant rise in new-onset heart failure was observed in HCM patients with T2DM.
- These findings remained significant after adjusting for major cardiovascular risk factors.
Conclusions:
- This study, one of the largest of its kind, demonstrates a significant association between T2DM and adverse outcomes in HCM patients.
- The results suggest T2DM should be considered a critical risk factor in the management and risk stratification of HCM.
- Further prospective research is warranted to elucidate the specific mechanisms and confirm these findings.
Background:
The mortality rate of hypertrophic cardiomyopathy (HCM) has decreased between 1999 and 2020. The risk factors for sudden cardiac death (SCD) in HCM were updated in the American Heart Association (AHA)/American College of Cardiology Foundation (ACCF) 2020 guidelines by adding new risk factors, like the late gadolinium enhancement on cardiac magnetic resonance imaging (MRI). Type 2 diabetes mellitus (T2DM) is a major risk factor for most cardiac diseases; however, it is not included in these guidelines due to a lack of strong evidence of a correlation between T2DM and mortality in HCM. Therefore, we sought to investigate if T2DM increases the 5-year risk rate for adverse outcomes, such as heart failure and all-cause mortality in patients with HCM.
Methods:
We collected patient data from January 1, 2018, to March 1, 2023, using the TriNetX database. The sample included 80,502 individuals with HCM, then divided into two cohorts based on the absence (58,573; cohort 1) or presence (15,296; cohort 2) of T2DM. The two matched groups then underwent survival and risk analyses for all-cause mortality or the first incidence of heart failure diagnosis within 5 years from the point in time when the selection criteria were first met.
Results:
We found a statistically significant increase in all-cause mortality and new-onset heart failure in HCM patients with diabetes compared to those without diabetes after adjusting for major risk factors.
Conclusions:
This is one of the largest retrospective cohort studies that examined the correlation between T2DM and adverse outcomes in patients with HCM. This underlines the need for future prospective studies investigating the effects of T2DM on HCM outcomes.
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