Diabetes increases heart failure mortality

Heart Attacks

Among adults who have a heart function disorder, even without any symptoms, diabetics have an increased risk of heart failure, hospitalization for heart failure, cardiovascular death and death from any cause.

The attention of cardiologists and diabetologists has recently been drawn to a disorder of the functioning of a ventricle of the heart during diabetes (“asymptomatic left ventricular systolic dysfunction”) which could be a risk factor for heart complications in diabetics. The frequent appearance of this disorder in diabetic people would even explain the particularly important efficacy of an anti-diabetic inhibitor SGLT2. Now, a new study has shown the reality and the potential gravity of this dysfunction.

In the new study, diabetic adults with heart dysfunction, and even without any symptoms, have an increased risk of developing true heart failure, hospitalization for acute decompensation of heart failure, or risk of death from sudden cardiac death or cardiovascular disease compared to non-diabetics.

This is evident in a British study published in Diabetes Care that analyzed left ventricular dysfunction studies involving 4,223 diabetics and non-diabetics. The study also reveals a higher risk of death in diabetics, whether or not they have heart failure.

The study was set up to determine the impact of diabetes on the evolution of heart function from a stage of asymptomatic left ventricular systolic dysfunction to a stage of proven heart failure. During a median follow-up of 36 months, 24.1% of adults without diabetes with this abnormality developed heart failure compared to 33.1% of diabetics.

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Compared to non-diabetics, diabetics also have higher risks of hospitalization for heart failure (P <0.0001), and deaths from heart failure (P <0.0001) and all-cause death (P = 0.001).

Before the development of heart failure, 5.9% of non-diabetic adults had myocardial infarction, compared with 5.6% of diabetics. The risk of heart failure, however, is significantly higher in diabetics than in non-diabetics, including taking into account the history of myocardial infarction in the statistical analysis.

The risk of hospitalization for heart failure is also higher in diabetics compared to non-diabetics (110 per 1,000 person-years versus 55 per 1,000 person-years, p <0,0001). The risk of death is lower in non-diabetics who did not develop heart failure compared to diabetics who did not develop heart failure (14% vs. 22%).

These findings should prompt more research on left ventricular systolic dysfunction in diabetics, which could lead to strategies to prevent its progression to proven heart failure.

Andrei Santov

Andrei, a sociologist by profession, born in Russia but currently located in UK, covers mostly European and Russia-related news for The Talking Democrat.