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

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 hospital...

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Detalles Bibliográficos
Autores: Lorido, JCA; Gomez, JC; Correa, MR; Iglesias, JR; Fernandez, TC; Camajuncosa, RJ; Izquierdo, MC; Guardiola, CJ; Pardo, LF; Ruiz, EP; Formiga, F; Bautista, PS
Tipo de documento: Artículo
Estado:Published version
Fecha de publicación:2022
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p14094
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/14094
Nivel de acceso:Acceso abierto
Palabra clave:Advanced heart failure
Diabetes Mellitus
Palliative care
Diabetes complications
Descripción
Sumario: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