Heart failure and T2D create a deadly combination

  • Zareini B & al.
  • Circ Cardiovasc Qual Outcomes
  • 23 Jun 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Heart failure (HF) is less common among patients with type 2 diabetes (T2D) than stroke, chronic kidney disease (CKD), or peripheral artery disease (PAD) but is more lethal.
  • Findings highlight importance of HF monitoring in patients with T2D.

Why this matters

  • Few data are available about mortality risk for different cardiovascular (CV) and renal diagnoses in patients after T2D diagnosis.

Study design

  • From Danish nationwide registers, the study population included 153,405 patients with newly diagnosed T2D during 1998-2015 and no prior CV or renal diagnosis.
  • Funding: Danish Heart Association; Boehringer Ingelheim.

Key results

  • During median 9.7-year follow-up, 45.1% (69,201) received a CV or renal diagnosis, including 12.6% ischemic heart disease (IHD), 4.7% stroke, 4.1% CKD, 3.0% PAD, and 2.2% HF.
  • Death risk within 5 years of T2D diagnosis was highest for those with HF (47.6%) vs those with PAD (37.1%), stroke (34.5%), CKD (27.7%), IHD (21.0%), and no other diagnosis (15.9%), respectively.
  • Compared with those not developing CV disease or CKD, reduced lifespan (in months; 95% CIs) with:
    • HF: 11.7 (11.6-11.8).
    • IHD: 1.6 (1.5-1.7).
    • Stroke: 6.4 (6.3-6.5).
    • CKD: 4.4 (4.3-4.6).
    • PAD: 6.9 (6.8-7.0).

Limitations

  • Lack of information on clinical factors reflecting HF and T2D severity, microvascular complications.