New T2D diagnosis: 5-year mortality is highest among those who develop HF

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

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Development of heart failure (HF) after a diagnosis of type 2 diabetes (T2D) poses the highest risk for mortality at 5 years, up to 5-fold greater than developing no cardiovascular disease (CVD).

Why this matters

  • The authors say that they hope the findings will encourage clinicians to regularly evaluate their patients with T2D for HF.

Key results

  • At each analysis year, ischemic heart disease (IHD) was the most commonly identified condition to develop, whereas HF was least common.
  • 5-year risk of death at 5 years post-T2D diagnosis was highest with HF: 47.6% (95% CI, 44.8%-50.3%).
  • For IHD, stroke, chronic kidney disease (CKD), and peripheral artery disease (PAD), this risk was
  • Risk ratios (95% CIs) for mortality at 5 years with:
    • HF: 3.0 (2.9-3.1).
    • IHD: 1.3 (1.3-1.4).
    • Stroke: 2.2 (2.1-2.2).
    • CKD: 1.7 (1.7-1.8).
    • PAD: 2.3 (2.3-2.4).
  • HF added to any of these diagnoses compounded mortality risk.
  • Analysis by age, sex, comorbidities, etc., did not change this pattern.

Study design

  • Data for 2 Danish registry cohorts (1998-2008 and 2009-2015), all patients with a new T2D diagnosis.
  • n=153,405; median follow-up of 9.7 (interquartile range, 5.8-13.9) years.
  • Annual landmark timepoints postdiagnosis were used to estimate 5-year outcomes.
  • Funding: Danish Heart Association; Boehringer Ingelheim.

Limitations

  • Severity of HF, T2D not known.