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Clinical Summary

Heart Failure Risk Higher in Type 2 Diabetes Complicated by IHD and ESRD

Takeaway

  • Patients with type 2 diabetes (T2D) who developed intercurrent ischaemic heart disease (IHD), end-stage renal disease (ESRD) or both, had a significantly higher risk of developing heart failure (HF) compared to those who did not develop IHD and ESRD.

Why this matters

  • Findings suggest that prevention of IHD and ESRD may be an effective way to delay or prevent HF development in patients with T2D.

Study design

  • This Danish nationwide cohort study included 285,024 patients (mean age 59 years) with new-onset T2D without previous history of HF between 1998 and 2015.
  • Funding: None disclosed.

Key results

  • During a median follow-up of 7.4 years, 19,960 (7%) patients developed incident HF.
  • The 5-year absolute risk of HF was lowest in patients with T2D without IHD or ESRD (4.02%; 95% CI, 3.90-4.15).
  • Patients with T2D complicated by IHD (11.51%; relative risk [RR], 2.86; 95% CI, 2.72-3.02) or ESRD (8.11%; RR, 2.02; 95% CI, 1.39-2.93; P<.001 for both) had an intermediate risk of HF.
  • Patients with T2D complicated by both IHD and ESRD had the highest risk (19.76%; RR, 4.92; 95% CI, 3.43-7.05; P<.001).
  • Patients with ESRD (RR, 1.47; 95% CI, 1.20-1.79) and with both IHD and ESRD (RR, 1.68; 95% CI, 1.41-1.99; P<.001 for both) were at an increased risk of mortality after HF diagnosis vs those with T2D without IHD and ESRD.

Limitations

  • Study did not consider other baseline risk factors, such as concomitant conditions and medical therapy

Malik ME, Madelaire C, D'Souza M, Blanche P, Kristensen SL, Kistorp C, Gustafsson F, Køber L, Rørth R, McMurray J, Sattar N, Gislason G, Torp-Pedersen C, Schou M. Risk of heart failure in type 2 diabetes complicated by incident ischaemic heart disease and end-stage renal disease. Eur. J. Heart Fail.2020 Apr 04 [Epub ahead of print]. doi: 10.1002/ejhf.1819. PMID: 32246806. View abstract

This clinical summary first appeared on Univadis from Medscape.

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