NDLI: Impact of diabetes mellitus on mortality in patients with acute heart failure: a prospective cohort study

Content Provider	Springer Nature : BioMed Central
Author	Kong, Min Gyu Jang, Se Yong Jang, Jieun Cho, Hyun-Jai Lee, Sangjun Lee, Sang Eun Kim, Kye Hun Yoo, Byung-Su Kang, Seok-Min Baek, Sang Hong Choi, Dong-Ju Jeon, Eun-Seok Kim, Jae-Joong Cho, Myeong-Chan Chae, Shung Chull Oh, Byung-Hee Lim, Soo Park, Sue K. Lee, Hae-Young
Abstract	Background Although more than one-third of the patients with acute heart failure (AHF) have diabetes mellitus (DM), it is unclear if DM has an adverse impact on clinical outcomes. This study compared the outcomes in patients hospitalized for AHF stratified by DM and left ventricular ejection fraction (LVEF). Methods The Korean Acute Heart Failure registry prospectively enrolled and followed 5625 patients from March 2011 to February 2019. The primary endpoints were in-hospital and overall all-cause mortality. We evaluated the impact of DM on these endpoints according to HF subtypes and glycemic control. Results During a median follow-up of 3.5 years, there were 235 (4.4%) in-hospital mortalities and 2500 (46.3%) overall mortalities. DM was significantly associated with increased overall mortality after adjusting for potential confounders (adjusted hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.03–1.22). In the subgroup analysis, DM was associated with higher a risk of overall mortality in heart failure with reduced ejection fraction (HFrEF) only (adjusted HR 1.14, 95% CI 1.02–1.27). Inadequate glycemic control (HbA1c ≥ 7.0% within 1 year after discharge) was significantly associated with a higher risk of overall mortality compared with adequate glycemic control (HbA1c < 7.0%) (44.0% vs. 36.8%, log-rank p = 0.016). Conclusions DM is associated with a higher risk of overall mortality in AHF, especially HFrEF. Well-controlled diabetes (HbA1c < 7.0%) is associated with a lower risk of overall mortality compared to uncontrolled diabetes. Trial registration ClinicalTrial.gov, NCT01389843. Registered July 6, 2011. https://clinicaltrials.gov/ct2/show/NCT01389843
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-020-01026-3.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-020-01026-3
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2020-05-02
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology Diabetes mellitus Acute heart failure Left ventricular ejection fraction Glycemic control
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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