Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study.

Autor: Lorido JCA; Internal Medicine Department, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz. Spain. Electronic address: joscarlor@gmx.es., Gómez JC; Internal Medicine Department, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz. Spain., Correa MR; Internal Medicine Department, Hospital de Rio Tinto, Av. de la Esquila, 5, 21660 Minas de Riotinto, Huelva., Iglesias JR; Internal Medicine Department, Vithas Hospital Valencia 9 de Octubre, Carrer de la Vall de la Ballestera, 59, 46015, Valencia. Electronic address: 28581jri@comb.cat., Fernández TC; Internal Medicine Department, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006 A Coruña. Electronic address: teresa.choucino.fernandez@sergas.es., Camajuncosa RJ; Internal Medicine Department, Hospital Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona. Electronic address: rjordana@tauli.cat., Izquierdo MC; Internal Medicine Department, Complejo Hospitalario de Soria, Carr. de Logroño, 0, 42005 Soria., Guardiola CJ; Internal Medicine Department, Hospital de la Vega Baja, Carretera Orihuela-Almoradí, S/N BAJO San Bartolomé, 03314, Orihuela Alicante., Pardo LF; Internal Medicine Department, Complejo Asistencial de Zamora, Av. de Requejo, 35, 49022 Zamora., Ruiz EP; Internal Medicine Department, Hospital Universitario de Getafe, Madrid. Carr. Madrid Toledo, Km 12,500, 28905 Getafe, Madrid., Formiga F; Internal Medicine Department, Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona. Electronic address: fformiga@bellvitgehospital.cat., Bautista PS; Internal Medicine Department, Hospital Universitario Virgen Macarena, Calle Dr. Fedriani, 3, 41009 Sevilla.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2022 Oct; Vol. 104, pp. 59-65. Date of Electronic Publication: 2022 Jul 22.
DOI: 10.1016/j.ejim.2022.07.014
Abstrakt: Aim: This work aims to compare the characteristics of advanced heart failure (HF) in patients with and without type 2 diabetes mellitus (DM) and to determine the relevance of variables used to define advanced HF.
Patients and Methods: This cross-sectional, multicenter study included patients hospitalized for HF. They were classified into four groups according to presence/absence of advanced HF, determined based on general and cardiac criteria, and presence/absence of DM. To analyze the importance of variables, we grew a random forest algorithm (RF) based on mortality at six months.
Results: A total of 3153 patients were included. The prevalence of advanced HF among patients with DM was 24% compared to 23% among those without DM (p=0.53). Patients with advanced HF and DM had more comorbidity related to cardiovascular and renal diseases; their prognosis was the poorest (log-rank <0.0001) though the adjusted hazard ratio by group in the Cox regression analysis was not significant. The variables that were significantly related to mortality were the number of comorbidities (p=0.005) and systolic blood pressure (p=0.024). The RF showed that general criteria were more important for defining advanced HF than cardiac criteria.
Conclusions: Patients with advanced HF and DM were characterized by DM in progression with macro and microvascular complications. The outcomes among advanced HF patients were poor; patients with advanced HF and DM had the poorest outcomes. General criteria were the most important to establish accurately a definition of advanced HF, being decisive the evidence of disease progression in patients with DM.
Competing Interests: Declaration of Competing Interest The authors of the present manuscript have nothing to disclose.
(Copyright © 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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