Clinical characteristics and prognosis of patients with ischemic heart failure and diabetes mellitus

  Background   Heart failure and diabetes are considered major epidemic diseases in modern times, and ischemic heart failure (IHF) is an important type of heart failure. However, there are few clinical studies on the comorbidity of IHF and diabetes in China.

  Objective   To analyze the clinical characteristics and prognosis of patients with IHF and diabetes mellitus.

  Methods   From February 2016 to January 2018, 430 patients with IHF admitted to the First Medical Center of Chinese PLA General Hospital were collected continuously. The patients were divided into comorbid group and IHF group according to whether they had diabetes. The baseline data of the two groups was matched by propensity score matching method. The major adverse cardiovascular and cerebrovascular events (MACCE) during the follow-up period were counted and survival prognosis of the two groups was analyzed.

  Results   There were 176 (40.9%) cases with diabetes mellitus in the IHF group (n=430), and 322 patients (161 cases in the comorbid group and 161 cases in the IHF group) were analyzed after the application of propensity score matching. The proportion of patients with NYHA class Ⅲ-Ⅳ in the comorbid group was higher (85.1% vs 73.9%, χ²=6.322, P=0.012) than that in the IHF group. The 6-minute walk test distance in the comorbid group was shorter than that in the IHF group (287.3±85.6 m vs 315.3±102.3 m,P=0.008). In subgroup analysis, male patients’ left ventricular end diastolic diameter in the comorbid group was greater than that in the IHF group (58.1±3.7 mm vs 57.0±2.8 mm, P=0.012). The median follow-up time was 40 months. The all-cause mortality in the comorbid group was higher than that in the IHF group (26.7% vs 15.5%, P=0.014). And the cumulative MACCE-free survival rate in the comorbid group was significantly lower than that in the IHF group (log rank χ2=8.623, P=0.003).

  Conclusion   Ischemic heart failure patients with diabetes mellitus have more severe clinical symptoms. And diabetes mellitus significantly increases all-cause mortality and MACCE risk in patients with ischemic heart failure.