Abstract 3176: Prognostic Value of Diabetes in Patients with Heart Failure According to Etiology. Data from the IN-CHF Registry
BACKGROUND. Diabetes (D) and ischemic etiology have been identified as independent predictors of increased mortality in patients (pts) with heart failure (HF). However, there are few data on the prognostic impact of D in ischemic compared with non ischemic cardiomyopathy.
AIM. To assess the relative prognostic impact of D according to the ischemic or non ischemic etiology of HF in an unselected population of outpts with HF.
METHODS. We performed an analysis on 4529 pts enrolled in the Registry of Italian Network on Congestive Heart Failure (IN-CHF). Each IN-CHF investigator clinically determined the etiology of HF and reported it in the database at the entry visit. Coronary angiography was not routinely performed, D was diagnosed on the basis of the clinical history, medications and laboratory findings. Univariate and multivariable analyses were performed to test the association between D and 1-year all-cause mortality and hospitalizations in patients with ischemic and non ischemic etiology.
RESULTS. Ischemic etiology accounted for 38.4% of the cases. The overall prevalence of D was 18.9%, but pts with ischemic etiology had an higher prevalence of D than those with non ischemic etiology (26.3% vs 14.2%, p<.0001). Diabetic pts had, in both cohorts, more frequently history of hypertension, anemia, impaired renal function and higher body mass index. Ischemic pts with D had more advanced HF (according to NYHA functional class) and were significantly less treated by beta blockers than those without D. One year outcome in pts stratified by etiology of HF is shown in the table⇓. In adjusted analysis diabetes remained an independent predictor of increased risk of death in ischemic pts (HR 1.66 95% CI 1.22–2.23) and in non ischemic pts (HR 1.47 95% CI 1.04–2.07).
CONCLUSIONS. The prognostic impact of diabetes in HF doesn’t seem to be determined by the etiology in this unselected population. D significantly correlates with a higher need of hospital admission.