Undiagnosed diabetes increases heart failure patient mortality
MedWire News: Undiagnosed diabetes is common in patients who are hospitalized for acute heart failure (HF) and is likely to result in increased total and cardiovascular mortality, say researchers.
Patients with acute HF have higher mortality than those with chronic stable HF, therefore identification of patients with underlying comorbidities who could benefit from more aggressive therapy is important for improving outcomes.
Juana Flores-Le-Roux (Hospital del Mar, Barcelona, Spain) and colleagues assessed the presence of diabetes (diagnosed and undiagnosed) in 400 consecutive patients admitted to hospital for acute HF. They evaluated its impact on all-cause and cardiovascular mortality over 7 years.
Previously undiagnosed diabetes, defined as having at least two fasting glucose measures of 7 mmol/l or above following admission to hospital, was present in 63 (16%) patients at baseline, a figure higher than the 10% suggested by the previous reports on undiagnosed diabetes in HF patients.
In addition, the team found that 188 (47%) of the patients had no diabetes and 149 (37%) had previously diagnosed diabetes at enrollment.
Writing in the journal Cardiovascular Diabetology, Flores-Le-Roux and co-investigators report that patients with undiagnosed diabetes had a significant 1.69- and 2.45-fold increased risk for 7-year total and cardiovascular mortality, respectively.
Similarly, patients with previously diagnosed diabetes had respective and significant 1.48- and 2.01-fold increased risks for these endpoints.
Interestingly, participants with undiagnosed diabetes had significantly lower rates of hypertension, dyslipidemia, peripheral vascular disease, and previous myocardial infarction than those with previously diagnosed diabetes, but similar rates of these comorbidities to HF patients without diabetes.
"These findings underscore the importance of identifying glucose abnormalities in heart failure patients," write the authors.
"This simple and cost-effective intervention permits identification of high-risk patients who could benefit from aggressive therapeutic interventions," they conclude.
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By Helen Albert