Diabetes outcomes in heart failure patients with hypertrophic cardiomyopathy

Mekhaimar, Menatalla; Mohannadi, Moza Al; Dargham, Soha R.; Suwaidi, Jassim Al; Jneid, Hani; Khalil, Charbel Abi

doi:10.3389/fphys.2022.976315

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Our data reinforce data from previous studies demonstrating that T2DM was associated with poorer outcomes in patients with HCM [10][11][12][13]. For example, a study in 2022 by Lee et al [11] analyzed adverse outcome risk between HCM patients with and without T2DM using data from the Korean National Health Insurance Service database.…”

Section: Discussionsupporting

confidence: 87%

Is Type 2 Diabetes Mellitus an Independent Risk Factor for Mortality in Hypertrophic Cardiomyopathy?

Hajouli,

Belcher,

Annie

et al. 2024

Cardiol Res

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Background The mortality rate of hypertrophic cardiomyopathy (HCM) has decreased between 1999 and 2020. The risk factors for sudden cardiac death (SCD) in HCM were updated in the American Heart Association (AHA)/American College of Cardiology Foundation (ACCF) 2020 guidelines by adding new risk factors, like the late gadolinium enhancement on cardiac magnetic resonance imaging (MRI). Type 2 diabetes mellitus (T2DM) is a major risk factor for most cardiac diseases; however, it is not included in these guidelines due to a lack of strong evidence of a correlation between T2DM and mortality in HCM. Therefore, we sought to investigate if T2DM increases the 5-year risk rate for adverse outcomes, such as heart failure and all-cause mortality in patients with HCM. Methods We collected patient data from January 1, 2018, to March 1, 2023, using the TriNetX database. The sample included 80,502 individuals with HCM, then divided into two cohorts based on the absence (58,573; cohort 1) or presence (15,296; cohort 2) of T2DM. The two matched groups then underwent survival and risk analyses for all-cause mortality or the first incidence of heart failure diagnosis within 5 years from the point in time when the selection criteria were first met. Results We found a statistically significant increase in all-cause mortality and new-onset heart failure in HCM patients with diabetes compared to those without diabetes after adjusting for major risk factors. Conclusions This is one of the largest retrospective cohort studies that examined the correlation between T2DM and adverse outcomes in patients with HCM. This underlines the need for future prospective studies investigating the effects of T2DM on HCM outcomes.

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Section: Discussionsupporting

confidence: 87%

Is Type 2 Diabetes Mellitus an Independent Risk Factor for Mortality in Hypertrophic Cardiomyopathy?

Hajouli,

Belcher,

Annie

et al. 2024

Cardiol Res

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“…Interestingly, cardiovascular risk factors, including smoking, dyslipidemia, and CAD, had a protective effect, a finding that we and others already reported in the NIS database ( 9 , 10 , 12 , 25 , 48 , 49 ). The paradoxical protective effect may be due to confounding factors not accounted for in our study, such as medications.…”

Section: Discussionsupporting

confidence: 82%

“…However, the landscape of diabetes has changed over the past decade. Despite the rise in the incidence of diabetes and its related complication, mortality in the general population is overall decreasing (8); which is also the case in clinical conditions such as heart failure, stroke, valvular heart disease, and hypertrophic cardiomyopathy (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Type 2 diabetes and in-hospital sudden cardiac arrest in ST-elevation myocardial infarction in the US

Mhaimeed

Pillai

Dargham

et al. 2023

Front. Cardiovasc. Med.

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AimsWe aimed to assess the impact of diabetes on sudden cardiac arrest (SCA) in US patients hospitalized for ST-elevation myocardial infarction (STEMI).MethodsWe used the National Inpatient Sample (2005–2017) data to identify adult patients with STEMI. The primary outcome was in-hospital SCA. Secondary outcomes included in-hospital mortality, ventricular tachycardia (VT), ventricular fibrillation (VF), cardiogenic shock (CS), acute renal failure (ARF), and the revascularization strategy in SCA patients.ResultsSCA significantly increased from 4% in 2005 to 7.6% in 2018 in diabetes patients and from 3% in 2005 to 4.6% in 2018 in non-diabetes ones (p < 0.001 for both). Further, diabetes was associated with an increased risk of SCA [aOR = 1.432 (1.336–1.707)]. In SCA patients with diabetes, the mean age (SD) decreased from 68 (13) to 66 (11) years old, and mortality decreased from 65.7% to 49.3% during the observation period (p < 0.001). Compared to non-diabetes patients, those with T2DM had a higher adjusted risk of mortality, ARF, and CS [aOR = 1.72 (1.62–1.83), 1.52 (1.43–1.63), 1.25 (1.17–1.33); respectively] but not VF or VT. Those patients were more likely to undergo revascularization with CABG [aOR = 1.197 (1.065–1.345)] but less likely to undergo PCI [aOR = 0.708 (0.664–0.754)].ConclusionDiabetes is associated with an increased risk of sudden cardiac arrest in ST-elevation myocardial infarction. It is also associated with a higher mortality risk in SCA patients. However, the recent temporal mortality trend in SCA patients shows a steady decline, irrespective of diabetes.

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“…During the past 2 decades, several reports have shown a temporal reduction in mortality following acute atherosclerotic cardiovascular disease in general and in the population with diabetes [23–26]. We have previously demonstrated a temporal mortality reduction in individuals with diabetes and heart failure [27], stroke [28], aortic valve replacement [29], and hypertrophic cardiomyopathy [30]. Contrary to our expectations, mortality in patients with STEMI and diabetes increased with time, except for underweight patients.…”

Section: Discussionmentioning

confidence: 99%

Overweight and obesity are associated with better survival inSTEMIpatients with diabetes

Chaudhry,

Bodair,

Mahfoud

et al. 2023

Obesity

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ObjectiveThe relationship between obesity and in‐hospital outcomes in individuals with type 2 diabetes mellitus (T2DM) who develop an ST‐elevation myocardial infarction (STEMI) was assessed.MethodsData from the National Inpatient Sample (NIS) from 2008 to 2017 were analyzed. Patients with STEMI and T2DM were classified as being underweight or having normal weight, overweight, obesity, and severe obesity. The temporal trend of those BMI ranges and in‐hospital outcomes among different obesity groups were assessed.ResultsA total of 74,099 patients with T2DM and STEMI were included in this analysis. In 2008, 35.8% of patients had obesity, and 37.3% had severe obesity. However, patients with obesity accounted for most of the study population in 2017 (57.8%). During the observation period, mortality decreased in underweight patients from 18.1% to 13.2% (p < 0.001). Still, it gradually increased in all other BMI ranges, along with cardiogenic shock, atrial fibrillation, and ventricular fibrillation (p < 0.001 for all). After the combination of all patients during the observation period, mortality was lower in patients with overweight and obesity (adjusted odds ratio = 0.625 [95% CI 0.499–0.784]; 0.606 [95% CI 0.502–0.733], respectively).ConclusionsA U‐shaped association governs the relationship between BMI and mortality in STEMI patients with diabetes, with those having overweight and obesity experiencing better survival.

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Diabetes outcomes in heart failure patients with hypertrophic cardiomyopathy

Cited by 5 publications

References 34 publications

Is Type 2 Diabetes Mellitus an Independent Risk Factor for Mortality in Hypertrophic Cardiomyopathy?

Is Type 2 Diabetes Mellitus an Independent Risk Factor for Mortality in Hypertrophic Cardiomyopathy?

Type 2 diabetes and in-hospital sudden cardiac arrest in ST-elevation myocardial infarction in the US

Overweight and obesity are associated with better survival inSTEMIpatients with diabetes

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