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Title: Association between type-2 diabetes mellitus and post-discharge outcomes in heart failure patients: Findings from the RICA registry
Authors: Carrasco-Sánchez, Francisco Javier
Gomez-Huelgas, Ricardo
Formiga, Francesc
Conde-Martel, Alicia 
Trullàs, Joan Carles
Bettencourt, Paulo
Arévalo-Lorido, José Carlos
Pérez-Barquero, Manuel Montero
UNESCO Clasification: 32 Ciencias médicas
320502 Endocrinología
Keywords: Diabetes
Heart failure
Issue Date: 2014
Journal: Diabetes Research and Clinical Practice 
Abstract: Aims: Heart failure (HF) and diabetes are common clinical conditions that may coexist. The main objective was to analyze the association of type-2 diabetes mellitus (T2DM) on prognosis in hospitalized patients with HF. Methods: We evaluated the association between T2DM with all-cause mortality and readmissions in the Spanish National Registry on Heart Failure-"Registro Nacional de Insuficiencia Cardiaca" (RICA). This is a multi-center and prospective cohort study that includes patients admitted for decompensated HF from 2008 to 2011. Study endpoints were all-cause mortality and hospital readmission. We determined the adjusted hazard ratio (HR) by a multivariable Cox regression model. Results: A total of 1082 patients (mean age 77.6±8.5) were included of whom 490 (45.3%) had diabetes and 592 patients (54.7%) had preserved left ventricular ejection fraction (LVEF). During one-year follow-up, 287 patients died (151 patients with diabetes) and 383 patients were readmitted (197 patients with diabetes). After adjusting for baseline characteristics T2DM was significantly associated with all-cause mortality (HR 1.54; 95%CI 1.20-1.97, p=0.001) and readmissions (HR 1.46; 95%CI 1.18-1.80, p<0.001). Age, dementia, peripheral vascular disease, NYHA class, renal insufficiency, hyponatremia and anemia were also independently associated with outcomes. There were no differences in mortality (p=0.415) and readmissions (p=0.514) according to preserved or reduced LVEF. Conclusion: T2DM is very common in patients hospitalized for HF. This condition is a strong and independent co-morbidity of all-cause mortality and readmission for both HF with preserved and reduced LVEF.
ISSN: 0168-8227
DOI: 10.1016/j.diabres.2014.03.015
Source: Diabetes Research and Clinical Practice[ISSN 0168-8227],v. 104, p. 410-419 (Junio 2014)
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