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ASSA13-13-4 The Impact of Diabetes Mellitus on Short-Term Prognosis of Patients with Congestive Heart Failure
  1. Weibo Joel Sim1,
  2. Yu Heng Kwan1,
  3. Kui Toh Gerard Leong2,
  4. Joanne Yeh Chang1,3
  1. 1Department of Pharmacy, National University of Singapore
  2. 2Department of Cardiology, Changi General Hospital
  3. 3Department of Pharmacy, Changi General Hospital

Abstract

Objective To analyse the effect of Diabetes Mellitus (DM) on 12-month outcomes of Congestive Heart Failure (CHF) patients and to identify risk factors associated with poorer outcomes.

Methods A prospective observational study was conducted at a secondary hospital between June 2006 and November 2012. Patients were followed up to 12 months or until death, if earlier. Clinical variables were reviewed and outcomes of mortality or hospitalizations were recorded. Multiple logistics regression was used to identify possible predictors of outcomes.

Results Out of 255 patients (46% non-DM, 54% DM), 122 (48%) were hospitalised and 16 (6%) died. All-cause hospitalisation (39% vs 55%; p = 0.012) and composite end-points (cardiovascular-related 33% vs 46%, p = 0.032; all-cause 41% vs 57%, p = 0.010) occurred at a lower rate in non-diabetics than diabetics. A hospitalisation of ≤7 days showed a lower risk of 12-month all-cause mortality (RR = 0.193, p = 0.001). Patients with non-ischemic cardiomyopathy also had a lower risk of all-cause hospitalisation compared to ischemic patients (31% vs 57%; p 7 mmol/L, NYHA Class II, NYHA Class III/IV independently predicted hospitalisation while age and NYHA Class II independently predicted mortality (all p (RR = 2.862, p = 0.013) while no difference was found with Angiotensin Converting Enzyme Inhibitors use.

Conclusions CHF patients with DM should be considered as a higher risk group for 12-month all-cause hospitalisation or mortality. This demands better strategies, especially in the optimization of both CHF and DM drug regimens to improve outcomes.

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