Is the prognosis in patients with diabetes and heart failure a matter of unsatisfactory management? An observational study from the Swedish Heart Failure Registry
2014 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 16, no 4, 409-418 p.Article in journal (Refereed) Published
To analyse the long-term outcome, risk factor panorama, and treatment pattern in patients with heart failure (HF) with and without type 2 diabetes (T2DM) from a daily healthcare perspective.
METHODS AND RESULTS:
Patients with (n = 8809) and without (n = 27 465) T2DM included in the Swedish Heart Failure Registry (S-HFR) 2003-2011 due to a physician-based HF diagnosis were prospectively followed for long-term mortality (median follow-up time: 1.9 years, range 0-8.7 years). Left ventricular function expressed as EF did not differ between patients with and without T2DM. Survival was significantly shorter in patients with T2DM, who had a median survival time of 3.5 years compared with 4.6 years (P < 0.0001). In subjects with T2DM. unadjusted and adjusted odds ratios (ORs) for mortality were 1.37 [95% confidence interval (CI) 1.30-1.44) and 1.60 (95% CI 1.50-1.71), and T2DM predicted mortality in all age groups. Ischaemic heart disease was an important predictor for mortality (OR 1.68, 95% CI 1.47-1.94), more abundant in patients with T2DM (59% vs. 45%) among whom only 35% had been subjected to coronary angiography and 32% to revascularization. Evidence-based pharmacological HF treatment was somewhat more extensive in patients with T2DM.
The combination of T2DM and HF seriously compromises long-term prognosis. Ischaemic heart disease was identified as one major contributor; however, underutilization of available diagnostic and therapeutic facilities for ischaemic heart disease was obvious and may be an important area for future improvement in patients with T2DM and HF.
Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 16, no 4, 409-418 p.
Diabetes; Heart failure; Mortality; Registry; Revascularization
IdentifiersURN: urn:nbn:se:liu:diva-109612DOI: 10.1002/ejhf.44ISI: 000346700000008PubMedID: 24464683OAI: oai:DiVA.org:liu-109612DiVA: diva2:739500