T2D Tied to Mortality in Both Ischemic and Nonischemic HF

TOPLINE:

Patients with type 2 diabetes (T2D) had approximately 20%-26% higher mortality rates following ischemic and nonischemic heart failure (HF) than those without diabetes, with similar patterns observed in both women and men.

METHODOLOGY:

• Most epidemiologic studies assessing mortality risk in individuals with HF, categorized by etiology and diabetes status, have relied on clinical trials or hospital data, limiting their generalizability to the broader population.
• Researchers conducted an observational retrospective cohort study using primary care and hospital data from England to examine the association between T2D and all-cause mortality in patients with ischemic or nonischemic HF.
• Patients with newly diagnosed T2D were matched with up to four people without diabetes on the basis of sex, birth year, and general practice.
• Incident HF events were defined as ischemic if they followed an ischemic heart disease event after the diagnosis of T2D; otherwise, they were classified as nonischemic. The outcome of interest was all-cause mortality.
• A total of 73,344 patients with HF were included, of whom 18,296 had ischemic HF and 55,048 had nonischemic HF. Among patients with ischemic HF, 2806 women (mean age, 77.26 years) and 4447 men (mean age, 73.44 years) had T2D, whereas among those with nonischemic HF, 10,094 women (mean age, 78.33 years) and 9964 men (mean age, 74.83 years) had T2D.

TAKEAWAY:

• During a median follow-up of 2.19 years for ischemic HF and 1.98 years for nonischemic HF, mortality was observed in 52.4% and 57.8% of patients, respectively.
• Age-standardized mortality rates following ischemic HF were higher in patients with T2D than in those without diabetes (19.2 vs 15.1 and 20.4 vs 16.5 per 100 person-years in women and men, respectively), with similar findings following nonischemic HF in women and men.
• T2D was associated with higher mortality rates following ischemic HF, with rates 26% higher in women (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.17-1.36) and 23% higher in men (aHR, 1.23; 95% CI, 1.15-1.31).
• Similarly, following nonischemic HF, T2D was associated with higher mortality rates in both women (aHR, 1.24; 95% CI, 1.19-1.29) and men (aHR, 1.20; 95% CI, 1.15-1.25).

IN PRACTICE:

“This [study] highlights the ongoing need to optimize the prevention and management strategies in the overall population of individuals with type 2 diabetes and HF to reduce the risk of premature mortality,” the authors of the study wrote.

SOURCE:

This study was led by Kajal Panchal, MSc, Leicester Diabetes Centre, University of Leicester, Leicester, England, and was published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

This study relied on health records that were collected routinely, which may have introduced measurement errors for certain covariates. The lack of data on echocardiography prevented distinguishing between HF with preserved or reduced ejection fraction. Additionally, confounding variables, such as body fat distribution, dietary factors, and physical activity, were either unavailable or poorly recorded in the databases.

DISCLOSURES:

This study was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands. Some authors reported being supported by the funding agency and NIHR Leicester Biomedical Research Centre. One author reported receiving consultancy fees, and another author reported being a consultant or speaker and receiving research grants from various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.