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Parity and Heart Failure Risk in Diabetic Women with Coronary Artery Disease: A Multicenter Cohort Study

Yuko Fujita1, Takeshi Morimoto2, Koichi Node3

  • 1Center for Clinical Research Support, Education and Management, University Hospital of the Ryukyus, Okinawa, Japan.

ESC Heart Failure
|August 19, 2026
PubMed

Insights

High parity, defined as five or more births, is linked to increased heart failure (HF) hospitalization risk in women with type 2 diabetes and coronary artery disease. This reproductive history factor is crucial for HF risk assessment in these high-risk patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Reproductive Health

Background:

  • Women with type 2 diabetes (T2DM) and coronary artery disease (CAD) have a higher risk of heart failure (HF) compared to men.
  • Existing research on parity and cardiovascular outcomes is limited in women with pre-existing cardiovascular disease.

Purpose of the Study:

  • To investigate the association between parity and the risk of HF hospitalization and mortality.
  • To determine if reproductive history influences cardiovascular outcomes in women with T2DM and CAD.

Main Methods:

  • A multicenter retrospective cohort study of 2,314 women with T2DM and CAD in Japan (2005-2022).
  • Participants were stratified by parity and followed for a median of 2,297 days.
  • Outcomes included HF hospitalization, all-cause mortality, acute myocardial infarction (AMI), and stroke, analyzed using Cox proportional hazards models.

Main Results:

  • Women with ≥5 births showed higher incidences of HF hospitalization (4.90 vs 3.03 per 100 person-years) and mortality (4.85 vs 3.76 per 100 person-years) compared to those with <5 births.
  • High parity (≥5 births) was significantly associated with HF hospitalization (HR: 1.41, 95% CI: 1.04-1.90) after adjustment.
  • No significant associations were found between high parity and mortality, AMI, or stroke.

Conclusions:

  • High parity independently predicts HF hospitalization in women with T2DM and CAD.
  • Reproductive history, specifically high parity, should be considered in HF risk stratification for high-risk women.
Abstract

Keywords:
cardiovascular diseasecoronary artery diseaseheart failureparitytype 2 diabetes mellitus

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