ABSTRACT
Background
Diabetes mellitus is associated with increased rates of mortality in patients with
less severe (stage C) heart failure (HF). The prevalence of diabetes and its complications
in advanced (stage D) HF and their contributions to mortality risk are unknown.
Methods and Results
We conducted a retrospective population-based cohort study of all adult residents
of Olmsted County, Minnesota, who had advanced HF between 2007 and 2017. Patients
with diabetes were identified by using the criteria of the Healthcare Effectiveness
Data and Information Set. Diabetes complications were captured by using the Diabetes
Complications Severity Index. Of 936 patients with advanced HF, 338 (36.1%) had diabetes.
Overall, median survival time after development of advanced HF was 13.1 (3.9–33.1)
months; mortality did not vary by diabetes status (aHR 1.06, 95% CI 0.90–1.25; P = 0.45) or by glycated hemoglobin levels in those with diabetes (aHR 1.01 per 1%
increase, 95% CI 0.93–1.10; P = 0.82). However, patients with diabetes and 4 (aHR 1.24, 95% CI 0.92–1.67) or 5–7
(aHR 1.49, 95% CI 1.09–2.03) diabetes complications were at increased risk of mortality
compared to those with ≤ 3 complications.
Conclusions
More than one-third of patients with advanced HF have diabetes. In advanced HF, overall
prognosis is poor, but we found no evidence that diabetes is associated with a significantly
higher mortality risk.
Key Words
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References
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Article info
Publication history
Published online: October 11, 2021
Accepted:
September 22,
2021
Received in revised form:
September 20,
2021
Received:
August 30,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
