Objective This study was designed to evaluate the prognostic impact of diabetes on diastolic heart failure (DHF) patients.
Methods We collected data on 359 consecutive patients with DHF (61±19 [SD] years, female 65.5%), defined by the Framingham criteria (history of congestive heart failure (CHF) with left ventricular ejection fraction (LVEF) ≥50%), from 2004 to 2009. Diabetes was defined by oral glucose-tolerance test. The main outcomes were death and re-hospitalisation. Secondary outcomes were new myocardial infarction (MI) and percutaneous coronary intervention (PCI). The outcomes were compared in DHF with diabetes and without diabetes patients.
Results The study population presented 40.7% of DHF patients with diabetes. The rates of total death and re-hospitalisation were 31.5% (37.9% among men and 28.1% among women) and 42.3% (46.8% among men and 40.0% among women), respectively. The in-hospital mortality was higher among women than among men (20.0% vs 16.9%, p<0.05). The rates of death and re-hospitalisation of DHF patients with diabetes were higher than that of DHF patients without diabetes (41.8% vs 24.4%, p<0.001) and (50.7% vs 36.6%, p<0.001). Furthermore, the mortality rate of DHF with diabetes patients increased with increasing courses of diabetes (17.6%, 35.4%, 57.1%, and 62.1% among patients who suffer from diabetes 1 to 5, 6 to 10, 11 to 15, and ≥15 years, respectively). The rates of new MI and PCI of DHF patients with diabetes were also higher than that of DHF patients without diabetes (26.7% vs 17.4%, p<0.01) and (19.2% vs 8.0%, p<0.01).
Conclusions These results indicate that the prognosis of DHF patients with diabetes is significantly poor. DHF patients with diabetes had a worse outcome than those patients without diabetes. Diabetes is an important modifiable risk factor in patients with DHF. Maybe strategies targeted at the prevention and therapy of diabetes can improve prognosis in DHF patients. And further investigation is needed.