Diabetes May Independently Predict Heart Failure

Diabetes may be an independent predictor of heart failure (HF), even in the absence of an underlying diastolic dysfunction, according to new findings published in Mayo Clinic Proceedings.

“These findings suggest that [diabetes mellitus] is an independent risk factor for the development of HF and supports the concept of [diabetes mellitus] cardiomyopathy,” the authors of the study wrote.

They arrived at their conclusion after performing a cross-sectional survey of 2042 Olmsted County residents aged 45 years or older June 1, 1997, through September 30, 2000. Participants were randomly selected through the Rochester Epidemiology Project. Their systolic and diastolic function was assessed via echocardiography. On average, follow-up lasted 10.8 years.

All participants with diabetes were compared with participants without diabetes and were matched for age, sex, hypertension, and coronary artery disease. The researchers compared between-group baseline characteristics, laboratory and echocardiography findings, and rates of mortality due to various cardiovascular conditions.

Ultimately, 116 participants with diabetes and 232 matched participants without diabetes were identified and included in the final analyses. Patients with diabetes were found to have a higher body mass index, as well as higher plasma insulin and serum glucose levels.

The results of the study indicated that E/e’ ratio was higher in participants with diabetes (9.7) compared with those without diabetes (8.5), despite similar ventricular ejection fractions between groups. Over the course of follow-up, participants with diabetes experienced a higher incidence of HF, with a hazard ratio (HR) of 2.1, compared with participants without diabetes. The 10-year Kaplan-Meier rate of HF was 21% in patients with diabetes compared with 12% in those without diabetes.

In a subgroup of participants without diastolic dysfunction, the researchers found that participants with diabetes had an increased risk of HF (HR 2.5) compared with those without diabetes.

—Christina Vogt

Reference:

Klajda MD, Scott CG, Rodeheffer RJ, Chen HH. Diabetes mellitus is an independent predictor for the development of heart failure. Mayo Clinic Proc. 2020;95(1):124-133. https://doi.org/10.1016/j.mayocp.2019.07.008.