T2DM Predicts Mortality in Patients with Heart Failure
(HealthDay News) — For patients with heart failure, the presence of type 2 diabetes mellitus (T2DM) predicts mortality, regardless of the presence of ischemic heart disease (IHD), according to a study published in the Sept. 27 issue of the Journal of the American College of Cardiology.
Isabelle Johansson, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined the impact of ischemic versus non-ischemic heart failure and previous revascularization on prognosis in a cohort of 35,163 heart failure patients with and without T2DM.
The researchers found that patients with T2DM were younger, and 90 percent had one or more associated comorbidities. Overall, IHD occurred in 62 and 47 percent of those with and without T2DM, respectively, of whom 53 and 48 percent, respectively, had undergone revascularization. Regardless of the presence of IHD, T2DM predicted mortality with adjusted hazard ratios of 1.40 and 1.30 for those with and without IHD, respectively. The highest mortality was seen for patients with both T2DM and IHD, which was elevated further by the absence of previous revascularization (adjusted hazard ratio, 0.82 in favor of such treatment). These results were not altered with propensity score adjustment. The impact of T2DM persisted after adjustment for revascularization; T2DM predicted mortality in those with and without a history of revascularization (hazard ratios, 1.36 and 1.45, respectively).
"IHD in patients with T2DM had an especially negative influence on mortality, an impact that was beneficially influenced by previous revascularization," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.