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CARDIOLOGY

Diabetes, or an independent risk factor for heart failure

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A new population-based study suggests that diabetes may be an independent risk factor for heart failure.The study was published online May 2 in Mayo Clinic Proceedings.Researchers tracked 116 diabetic patients and 232 matched control subjects over a 10-year period and found that 1 in 5 diabetic patients had heart failure and had nothing to do with other causes (such as diastolic dysfunction), while non-diabetic patients1/10 suffer from heart failure.Research by Dr. Michael Klajda’s team at the Mayo Clinic has shown that patients with diabetes have a significantly increased risk of heart failure compared to those without diabetes.Even without structural heart disease (diastolic dysfunction), people with diabetes are still at risk of developing heart failure.These findings support the concept of diabetic cardiomyopathy (DCM).Research Summary The researchers used data from the Rochester Epidemiology Project (REP). The final sample included 116 diabetic patients over 45 years of age and 232 matched controls with age, hypertension, gender, coronary artery disease, and diastolic dysfunction.By.During follow-up, participants were regularly monitored for mortality and endpoints for heart failure, myocardial infarction, and stroke.At baseline, patients with diabetes had a higher BMI than those without diabetes, and had higher rates of AF, heart failure, and metabolic syndrome, and higher triglyceride levels.Diabetics do not use newer hypoglycemic drugs, such as SGLT-2 inhibitors and DPP-4 inhibitors.The E / e ′ ratio was higher in diabetic patients, but there was no statistical difference in EF, left atrial size, and diastolic dysfunction between the two groups.During a follow-up of 10.8 years, the risk of heart failure was higher in patients with diabetes than in those without diabetes, with a hazard ratio (HR) of 2.1 (95% CI, 1.2-3.6; P = 0.01).In the 1 year from the initial data collection, 4% of diabetic patients developed heart failure; at 5 years, 14% developed heart failure; and at 10 years, 21% and 12% of the two groups had heart failure.There were no statistical differences between the two groups in terms of cardiogenic death, myocardial infarction, stroke, and all-cause mortality.The researchers compared the subgroup of participants without diastolic dysfunction with their matched control subgroup and found that patients with diabetic dysfunction at baseline also had an increased risk of heart failure at 10 years compared with those without diabetes (HR, 2.595% CI, 1.0-6.3; P = 0.04).At 10 years, although death, cardiac death, myocardial infarction, and stroke were similar, 13% of the diabetic group developed heart failure, compared with only 7% of the non-diabetic group.In this cohort, even without potential diastolic dysfunction, the incidence of heart failure in patients with diabetes increased during 10 years of follow-up.These findings indicate that diabetes is an independent risk factor for heart failure and supports the concept of diabetic cardiomyopathy.The overall size of this study cohort is small, and the results need to be validated in large-scale studies.Future research should focus on whether actively managing risk factors reduces the risk of heart failure in people with diabetes, such as BMI, blood glucose, and cholesterol levels.

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