Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study
Por:
Lorido, J, Gomez, J, Correa, M, Iglesias, J, Fernandez, T, Camajuncosa, R, Izquierdo, M, Guardiola, C, Pardo, L, Ruiz, E, Formiga, F and Bautista, P
Publicada:
1 oct 2022
Ahead of Print:
1 sep 2022
Categoría:
Internal medicine
Resumen:
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
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