Effect of Transthoracic Echocardiography on Prognosis Outcomes in Diabetic Patients With Various Cardiovascular...

This study aimed to investigate the association between transthoracic echocardiography (TTE) and prognosis in diabetic patients without complications who present with seven types of cardiovascular diseases.

Data were sourced from the Medical Information Mart for Intensive Care (MIMIC)-IV database (N = 5553). The included participants were divided into TTE examination (n = 2263) and non-TTE examination (n = 3290) groups. Clinical endpoints included survival time, initial Intensive Care Unit (ICU) admission, and hospital readmission. Logistic and Cox regression analyses were conducted to assess the relationship between TTE examination and these outcomes. Receiver operating characteristic (ROC) curves evaluated the predictive exploratory prognosis utility of TTE examination. The Kaplan-Meier (KM) and restricted mean survival time (RMST) analyses were used to compare the survival difference between the TTE examination and non-TTE examination groups.

Significant differences were observed in the distribution of the other three outcomes between the TTE examination and non-TTE examination groups (all p < 0.05). However, only the association between TTE and survival time was influenced by whether the patient had cardiovascular diseases (observed only in patients with cardiovascular diseases, all p < 0.05). KM and RMST analyses further showed that TTE examination was associated with dual benefits in longer survival time and extended event-free survival time compared with the non-TTE examination group (all p < 0.05). Cox regression analysis indicated a negative correlation in patients specifically with coronary heart disease, heart failure, cardiomyopathy, or hypertension (all p < 0.05), but observed an independent association only in subgroups with heart failure (p = 0.012) or cardiomyopathy (p = 0.035). Exploratory ROC analysis demonstrated the clinical significance of TTE, particularly in predicting long-term survival (exceeding the 75th percentile) among diabetic patients with heart failure (all DeLong test p < 0.05).

TTE was independently associated with survival time in diabetic patients with heart failure or cardiomyopathy, and exploratory analyses suggested more favorable performance in predicting the longer survival duration among those with heart failure.