Co-incident diabetes increases complications for Asian heart failure patients
New research has observed that, amongst Asian heart failure patients, type 2 diabetes co-incidence is associated with increased risk of complications and mortality, compared with non-diabetic individuals.
The prevalence of type 2 diabetes has increased worldwide and diabetes is often co-incident with heart failure diagnosis. The relationship between this co-morbidity has been extensively evaluated amongst patients of Western populations. Now, an international team of researchers have extended this body of work and assessed the relationship between diabetes and heart failure complications, specifically considering heart failure phenotype, amongst patients of Asian ethnicity.
In the study, researchers assessed data on 6167 heart failure patients from the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) Study – the first prospective, multinational Asian registry of patients with symptomatic heart failure.
Researchers compared the echocardiographic parameters, quality of life – evaluated through the use of Kansas City Cardiomyopathy Questionnaire – and all-cause mortality rates of heart failure patients with and without co-incident diabetes.
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5028 patients presented with reduced ejection fraction heart failure and 40% of this cohort had co-incident type 2 diabetes.
Of the remaining 1139 study participants, who had preserved ejection fraction heart failure, 45% had co-morbid diabetes.
In both heart failure phenotype cohorts, patients who had type 2 diabetes mellitus also had greater structural abnormalities of the heart and increased risks of repeat hospitalization and death within 1 year of diabetes diagnosis.
Patients with preserved ejection fraction heart failure had concentric hypertrophy and lower quality of life scores compared with patients with reduced ejection fraction heart failure.
Jonathan Yap, a Consultant from the department of cardiology of the National Heart Centre Singapore and study co-author, commented: “Primary prevention strategies and tailored treatment options are needed to tackle this twin scourge of diseases…Our findings emphasize the need for preventative public health measures at the community and primary care level. For heart failure patients who have diabetes, physicians should closely monitor and optimize their management.”
Yap J, Tay WT, Teng T-HK et al. Association of Diabetes Mellitus on Cardiac Remodeling, Quality of Life, and Clinical Outcomes in Heart Failure With Reduced and Preserved Ejection Fraction. J. Am. Heart Assoc. 8: e013114; (Epub ahead of print) (2019);
Diabetes can itself act as a significant risk factor for the development of heart failure, as well as in combination with other co-morbidities such as hypertension and obesity. Strict blood glucose control can greatly reduce this risk.
Long-term diabetes can result in damage to the blood vessels that supply blood to your heart. This can cause your heart to function less efficiently, as occurs in congestive heart failure.