Abstract
Background: Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection fraction (HFpEF) are not well described. Methods: Using the Get With The Guidelines (GWTG)–HF Registry linked to Centers for Medicare & Medicaid Services claims data, we evaluated differences between HF patients with and without diabetes. Adjusted Cox proportional-hazard models controlling for patient and hospital characteristics were used to evaluate mortality and readmission outcomes. Results: A cohort of 86,659 HF patients aged ≥65 years was followed for 3 years from discharge. Unadjusted all-cause mortality was between 4.4% and 5.5% and all-cause hospitalization was between 19.4% and 22.6% for all groups at 30 days. For all-cause mortality at 3 years from hospital discharge, diabetes was associated with an adjusted hazard ratio of 1.27 (95% CI 1.07-1.49, P =.0051) for HFrEF, 0.95 (95% CI 0.55-1.65, P =.8536) for HFbEF, 1.02 (95% CI 0.87-1.19, P =.8551) for HFpEF. For all-cause readmission, diabetes was associated with an adjusted hazard ratio of 1.06 (95% CI 0.87-1.29, P =.5585) for HFrEF, 1.48 (95% CI 1.15-1.90, P =.0023) for HFbEF, and 1.06 (95% CI 0.91-1.22, P =.4747) for HFpEF. Conclusions: HFrEF and HFbEF patients with diabetes are at increased risk for mortality and rehospitalization after hospitalization for HF, independent of other patient and hospital characteristics. Among HFpEF patients, diabetes does not appear to be independently associated with significant additional risks.
Original language | English (US) |
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Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | American heart journal |
Volume | 211 |
DOIs | |
State | Published - May 2019 |
Funding
Funding: The Get With The Guidelines–Heart Failure (GWTG-HF) program is provided by the American Heart Association (AHA). GWTG-HF is sponsored, in part, by Amgen Cardiovascular and has been funded in the past through support from Medtronic, GlaxoSmithKline, Ortho-McNeil, and the AHA Pharmaceutical Roundtable. B. Ziaeian is supported by the ACC Presidential Career Developmental Award and AHA SDG 17SDG33630113.This project was supported by the American Heart Association's GWTG program and the American College of Cardiology Presidential Career Development award. No person or organization outside of the authors contributed in any substantive way to writing, editing, or statistical analyses reported in this manuscript. Funding: The Get With The Guidelines–Heart Failure (GWTG-HF) program is provided by the American Heart Association (AHA). GWTG-HF is sponsored, in part, by Amgen Cardiovascular and has been funded in the past through support from Medtronic, GlaxoSmithKline, Ortho-McNeil, and the AHA Pharmaceutical Roundtable. B. Ziaeian is supported by the ACC Presidential Career Developmental Award and AHA SDG 17SDG33630113 .
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine