Diabetes mellitus is associated with adverse prognosis in chronic heart failure of ischaemic and non-ischaemic aetiology
Abstract
BACKGROUND: It is unclear whether diabetes mellitus (DM) is an adverse prognostic factor in chronic heart failure (CHF) of ischaemic and non-ischaemic aetiology managed with contemporary evidence-based care. METHODS: In total, 1091 outpatients with CHF with reduced ejection fraction were prospectively observed for a mean of 960 days. Total and cardiovascular mortality was quantified after accounting for potential confounders. RESULTS: In total, 25.7% of patients had DM; this group was more likely to have CHF of ischaemic aetiology and was more symptomatic. Patients with DM received comparable medical- and device-based therapies, except for greater doses of loop diuretic. DM was associated with approximately doubled crude and adjusted risk of total and cardiovascular mortality. The association of diabetes with these outcomes in patients with ischaemic and non-ischaemic cardiomyopathies was of similar magnitude. CONCLUSIONS: In spite of advances in the management of CHF, DM remains a major adverse prognostic feature, irrespective of ischaemic/non-ischaemic aetiology.
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Patients with T2DM and HF are at increased risk of malignant ventricular arrhythmias and SCD.
“In addition to a higher risk of death due to worsening HF, patients with T2DM and HF are at increased risk of malignant ventricular arrhythmias and SCD.”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [75]
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“The principal findings of this study are as follows: (1) DM remains an adverse prognostic factor in patients with CHF receiving contemporary evidence-based therapy and (2) DM impacts similarly upon total and cardiovascular mortality in ischaemic and non-ischaemic cardiomyopathies.”
ResultDiabetes, left ventricular systolic dysfunction, and chronic heart failure
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- Authors
- Cubbon, R. M., Adams, B., Rajwani, A., Mercer, B. N., Patel, P. A., Gherardi, G., Gale, C. P., Batin, P. D., Ajjan, R., Kearney, L., Wheatcroft, S. B., Sapsford, R. J., Witte, K. K., & Kearney, M. T.
- Affiliations
- University of Leeds (GB)
- Leeds General Infirmary (GB)
- Multidisciplinary Cardiovascular Research Centre, The University of Leeds, Leeds, UK
- Mid Yorkshire Hospitals NHS Trust (GB)
- ORCID
- Venue
- Diabetes and Vascular Disease Research
- Publisher
- SAGE Publications
- Published
- 2013-01-24
- Volume
- 10
- Issue
- 4
- Pages
- 330-336
- ISSN
- 1479-1641 (ISSN-L)
- 1752-8984
- OpenAlex
- W2139339820
- Cited by
- 167
- References
- 13
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 10 · 2023: 9 · 2022: 8 · 2021: 6 · 2020: 22 · 2019: 17 · 2018: 26 · 2017: 18 · 2016: 20 · 2015: 9 · 2014: 12 · 2013: 1
- FWCI
- 9.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes and Vascular Disease Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2013-02-003)
- British Heart Foundation (FS/11/73/29014, FS/12/80/29821, PG/08/020/24617)
- Medical Research Council (MR/J00281X/1)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- diabetes mellitus, chronic heart failure, ischemic heart failure, non-ischemic heart failure, prognosis, cardiovascular mortality, all-cause mortality, reduced ejection fraction, ischemic cardiomyopathy, non-ischemic cardiomyopathy, loop diuretics, device therapy
- MeSH terms
- Aged, Chronic Disease, Female, Heart Failure, Humans, Male, Middle Aged, Prognosis, Risk Factors, Myocardial Ischemia, Diabetes Complications
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