Changes over time in the association between type 2 diabetes and post-discharge outcomes in decompensated chronic heart failure patients: Findings from the RICA Registry
Por:
Carrasco-Sanchez, F, Paez-Rubio, M, Arevalo-Lorido, J, Carretero-Gomez, J, Conde-Martel, A, Epelde, F, Alvarez-Rocha, P, Salamanca-Bautista, M, Cepeda-Rodrigo, J, Montero-Perez-Barquero, M and RICA Registry Working Grp
Publicada:
1 feb 2022
Categoría:
Medicine (miscellaneous)
Resumen:
Aims: Heart failure (HF) and diabetes are 2 strongly associated diseases. The main objective of this work was to analyze changes in the prognosis of patients with diabetes who were admitted for heart failure in 2 time periods.
Methods: This work is a prospective study comparing prognosis at one year of follow-up among patients with diabetes who were hospitalized for HF in either 2008-2011 or 2018. The patients are from the Spanish Society of Internal Medicine's National Heart Failure Registry (RICA, for its initials in Spanish). The primary endpoint was to analyze the composite outcome of total mortality and/or readmission due to HF in 12 months. A multivariate Cox regression model was used to evaluate the strength of association (hazard ratio [HR]) between diabetes and the outcomes between both periods.
Results: A total of 936 patients were included in the 2018 cohort, of which 446 (48%) had diabetes. The baseline characteristics of the populations from the 2 periods were similar. In patients with diabetes, the composite outcome was observed in 233 (47.5%) in the 2008-2011 cohort and 162 (36%) in the 2018 cohort [HR 1.48; 95% confidence interval (95%C1) 1.18-1.85; p < .001]. The proportion of readmissions (HR 1.39; 95%CI 1.07-1.80; p= .015) and total mortality (HR 1.60; 95%CI 1.20-2.14; p< .001) were also significantly higher in patients with diabetes from the 2008-2011 cohort compared to the 2018 cohort.
Conclusions: In 2018, an improvement was observed in the prognosis for all-cause mortality and readmissions over one year of follow-up in patients with diabetes hospitalized for HF compared to the 2008-2011 period. (C) 2021 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Filiaciones:
Carrasco-Sanchez, F:
Hosp Univ Juan Ramon Jimenez, UGC Med Interna & Cuidados Paliativos, Area Insuficiencia Cardiaca Diabet & Riesgo Vasc, Huelva, Spain
Paez-Rubio, M:
Hosp Univ Juan Ramon Jimenez, UGC Med Interna & Cuidados Paliativos, Area Insuficiencia Cardiaca Diabet & Riesgo Vasc, Huelva, Spain
Arevalo-Lorido, J:
Hosp Zafra, Serv Med Interna, Badajoz, Spain
Carretero-Gomez, J:
Hosp Zafra, Serv Med Interna, Badajoz, Spain
Conde-Martel, A:
Hosp Univ Gran Canaria Dr Negrin, Serv Med Interna, Las Palmas Gran Canaria, Las Palmas, Spain
Epelde, F:
Hosp Univ Parc Tauli, Unidad Estancia Corta, Barcelona, Spain
Alvarez-Rocha, P:
Hosp Clin Dr Manuel Quintela, Unidad Multidisciplinaria Insuficiencia Cardiaca, Montevideo, Uruguay
Salamanca-Bautista, M:
Hosp Univ Virgen Macarena, Serv Med Interna, Seville, Spain
:
Hosp Vega Baja, Serv Med Interna, Alicante, Spain
Montero-Perez-Barquero, M:
Univ Cordoba, IMIBIC Hosp Reina Sofia, Serv Med Interna, Cordoba, Spain
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