Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study

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 hospital...

Descripción completa

Detalles Bibliográficos
Autores: Lorido, JCA, Gomez, JC, Correa, MR, Iglesias, JR, Fernandez, TC, Camajuncosa, RJ, Izquierdo, MC, Guardiola, CJ, Pardo, LF, Ruiz, EP, Formiga, F, Bautista, PS
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p14094
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/14094
Access Level:acceso abierto
Palabra clave:Advanced heart failure
Diabetes Mellitus
Palliative care
Diabetes complications
Descripción
Sumario: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