Pre-existing type 2 diabetes is associated with increased all-cause death independently of echocardiographic predictors of poor prognosis only in ischemic heart disease

Stefano Ghio, Catherine Klersy, Erberto Carluccio, Angela B Scardovi, Laura Scelsi, Calogero Falletta, Andrea Rossi, Pompilio Faggiano, Egidio Traversi, Olga Vriz, Marco Guazzi, Frank L Dini, Giovanni Targher, Pier L Temporelli

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND AND AIMS: It is unknown whether the prognostic role of diabetes (T2DM) in outpatients with chronic heart failure (CHF) is independent of the most important echocardiographic markers of poor prognosis. The aims of this analysis were to evaluate whether T2DM modifies the risk of mortality in CHF patients stratified by etiology of disease or by right-ventricular to pulmonary arterial coupling at echocardiography and to evaluate how T2DM interacts with the prognostic role of cardiac plasma biomarkers.

METHODS AND RESULTS: This is a retrospective analysis of 1627 CHF outpatients who underwent a complete echocardiographic examination. During a median follow-up period of 63 months 255 patients died. Poor right-ventricular to pulmonary arterial coupling and reduced left ventricular ejection fraction were independent predictors of outcome, whereas ischemic etiology and T2DM were not. T2DM interacted with etiology increasing the risk of mortality by 32% among patients with ischemic disease (p = 0.003). Elevated hsTNI plasma levels were associated with poor survival in T2DM but not in non-diabetic patients.

CONCLUSION: T2DM signals a worse outcome in ischemic CHF patients regardless of the echocardiographic phenotype. High plasma levels of hsTNI are stronger predictors of mortality in CHF patients with T2DM than in patients without diabetes.

Original languageEnglish
Pages (from-to)2036-2040
Number of pages5
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume30
Issue number11
DOIs
Publication statusPublished - Oct 30 2020

Keywords

  • Aged
  • Biomarkers/blood
  • Cause of Death
  • Diabetes Mellitus, Type 2/diagnosis
  • Echocardiography
  • Female
  • Heart Disease Risk Factors
  • Heart Failure/diagnostic imaging
  • Hemodynamics
  • Humans
  • Male
  • Myocardial Ischemia/diagnostic imaging
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Troponin I/blood
  • Ventricular Function, Left

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