Diabetes tied to increased heart failure risk in patients with left ventricular systolic dysfunction

  • Rørth R & al.
  • Diabetes Care
  • 6 Apr 2018

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • In patients with asymptomatic left ventricular systolic dysfunction (ALVSD), diabetes was associated with significantly higher risk of developing heart failure (HF), HF hospitalisation and cardiovascular death.
  • Mortality risk associated with HF was high irrespective of diabetes status.

Why this matters

  • Co-existence of both diabetes and HF is associated with the risk of adverse cardiovascular outcomes.  
  • Study findings may provide development of strategies to prevent the transition from ALVSD to overt HF.

Study design

  • Retrospective analysis of 4223 patients (no diabetes, n=3576; diabetes, n=647) using data from the Studies of Left Ventricular Dysfunction (SOLVD-P)
  • The median follow-up duration was 36 months.
  • Funding: None disclosed.

Key results

  • During the follow-up duration, 861 of the 3576 patients without diabetes (24%) developed HF compared with 214 of the 647 patients with diabetes (33%).
  • Risk for development of HF was significantly high among patients with diabetes (adjusted HR [aHR], 1.30; 95% CI, 1.11-1.52; P=.001) vs patients without diabetes.
  • Among patients with diabetes, significantly higher risk was seen for HF hospitalisation (aHR, 1.75; 95% CI, 1.40-2.19), all-cause mortality (1.43; 1.17-1.74) and cardiovascular death (1.42; 1.14-1.76).
  • Relative risk for mortality was found to be similar in both the groups.

Limitations

  • Retrospective study design.
  • Data on type and duration of diabetes, HbA1c, and medication used was unavailable.