VIENNA – Among patients with ischemic heart failure, type 2 diabetes increased the risk of death by 70% over 2 years.
Even patients with a prior revascularization were in danger, with a 60% increased risk of death. The findings were slightly better for patients with a preserved ejection fraction of at least 50%; type 2 diabetes increased their mortality risk by 40%, Dr. Anna Norhammar and Dr. Isabelle Johansson of Karolinska Institute, Stockholm, reported at the annual meeting of the European Society for the Study of Diabetes.
The results were drawn from the large Swedish Heart Failure Registry. It contains data on about 41,000 patients who have been treated for heart failure since 2003. Of these, 17,673 had ischemic heart failure, and 30% had both type 2 diabetes and ischemic heart failure.
These patients were younger than those without diabetes (75 vs. 77 years), and congestive heart failure of at least 6 months was present in 61% of those with diabetes and 54% of those without it. Those with diabetes had more severe heart failure, with a New York Heart Association class of III/IV in 53%, compared with 46% of those without diabetes, Dr. Norhammar reported.
Hypertension and atrial fibrillation were significantly more common among those with diabetes. A prior revascularization had occurred in 48% of those without diabetes, compared with 54% of those with diabetes.
In a multivariate model that adjusted for 29 variables, the investigators found that type 2 diabetes increased the risk of death by 70% over a median follow-up of 22 months. Prior revascularization cut the risk by 60%.
Dr. Johansson presented a separate analysis of patients who had a preserved ejection fraction of at least 50% (6,705). Of these, 1,658 had type 2 diabetes. Again, these patients were younger (76 vs. 78 years), more likely to have congestive heart failure (53% vs. 48%), and more likely to be in the NYHA class III/IV (44% vs. 39%). More of those with diabetes had concomitant ischemic heart disease, hypertension, atrial fibrillation, and valvular heart disease.
In this multivariate analysis, having type 2 diabetes increased the risk of death by 40%, Dr. Johansson said.
Dr. Norhammar and Dr. Johansson had no relevant financial disclosures.