Impact of type 2 diabetes mellitus on mid-term mortality for hypertrophic cardiomyopathy patients who underwent septal myectomy

Wang, Shengwei; Cui, Hao; Ji, Keshan; Song, Changpeng; Ren, Changwei; Guo, Hongwei; Zhu, Changsheng; Wang, Shuiyun; Lai, Yongqiang

doi:10.1186/s12933-020-01036-1

Cited by 8 publications

(5 citation statements)

References 27 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 - 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: 92%

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: 92%

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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“…Comorbid medical conditions are important contributors to the development of arrhythmias in non-HCM cardiac conditions, [1][2][3][4][5][6][7] and while obesity and other comorbidities in HCM have been linked to heart failure progression, [15][16][17][18][19][20][21] We found no evidence that obesity or other comorbidities impact risk for SCD in HCM. Indeed, HCM patients with SCD events were younger, had similar BMI, and were less likely to have diabetes, hypertension, or hyperlipidemia than HCM patients without such events.…”

Section: Discussioncontrasting

confidence: 58%

“…8,9 More recently, obesity and other comorbidities have been demonstrated to impact clinical course in HCM, primarily via their impact on outflow obstruction and progressive heart failure. [15][16][17][18][19][20][21] However, whether such comorbidities affect development of clinically relevant arrhythmias in HCM remains unresolved. Therefore, we have taken the opportunity to evaluate the potential impact of obesity and other comorbidities on development of AF and SCD events in a large consecutive cohort of HCM patients.…”

mentioning

confidence: 99%

Impact of comorbidities on atrial fibrillation and sudden cardiac death in hypertrophic cardiomyopathy

Sridharan

Maron

Carrick

et al. 2021

Cardiovasc electrophysiol

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Background: The impact of comorbid disease states on the development of atrial and ventricular arrhythmias in patients with hypertrophic cardiomyopathy (HCM) remains unresolved.Objective: Evaluate the association of comorbidities linked to arrhythmias in other cardiovascular diseases (e.g., obesity, systemic hypertension, diabetes, obstructive sleep apnea, renal disorders, tobacco, and alcohol use) to atrial fibrillation (AF) and sudden cardiac death (SCD) events in a large cohort of HCM patients.Methods: A total of 2269 patients, 54 ± 15 years of age, 1392 males, were evaluated at the Tufts HCM Institute between 2004 and 2018 and followed for an average of 4 ± 3 years for new-onset clinical AF and SCD events (appropriate defibrillation for ventricular tachyarrhythmias, resuscitated cardiac arrest, or SCD).Results: One or more comorbidity was present in 75% of HCM patients, including 50% with ≥2 comorbidities, most commonly obesity (body mass index [BMI] ≥ 30 kg/m 2 ) in 43%. New-onset atrial fibrillation developed in 11% of our cohort (2.6%/year).On univariate analysis, obesity was associated with a 1.7-fold increased risk for AF (p = .03) with 12% of obese patients developing AF (3.3%/year) as compared to 7% of patients with BMI < 25 kg/m 2 (1.6%/year; p = .006). On multivariate analysis, age and LA transverse dimension emerged as the only variables predictive of AF. Comorbidities, including obesity, were not independently associated with AF development (p > .10 for each). SCD events occurred in 3.3% of patients (0.8%/year) and neither obesity nor other comorbidities were associated with increased risk for SCD (p > .10 for each).

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“…However, the difference in mortality was only significant in the last 5 years of the 15-year follow-up; the first 5 years of the study showed lower mortality in the presence of diabetes, which is concordant with our results. Another study looking at outcomes after septal myectomy in 201 HCM patients and comparing diabetes versus non-diabetes patients found identical mortality in both groups (Wang et al, 2020). Analysis of the OPTIMIZE-HF registry found that diabetes did not affect in-hospital mortality (Greenberg et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Diabetes outcomes in heart failure patients with hypertrophic cardiomyopathy

et al. 2022

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Aims: We aimed to assess diabetes outcomes in heart failure (HF) patients with hypertrophic cardiomyopathy (HCM).Methods: The National Inpatient Sample database was analyzed to identify records from 2005 to 2015 of patients hospitalized for HF with concomitant HCM. We examined the prevalence of diabetes in those patients, assessed the temporal trend of in-hospital mortality, ventricular fibrillation, atrial fibrillation, and cardiogenic shock and compared diabetes patients to their non-diabetes counterparts.Results: Among patients with HF, 0.26% had HCM, of whom 29.3% had diabetes. Diabetes prevalence increased from 24.8% in 2005 to 32.7% in 2015. The mean age of patients with diabetes decreased from 71 ± 13 to 67.6 ± 14.2 (p < 0.01), but the prevalence of cardiovascular risk factors significantly increased. In-hospital mortality decreased from 4.3% to 3.2% between 2005 and 2015. Interestingly, cardiogenic shock, VF, and AF followed an upward trend. Age (OR = 1.04 [1.03–1.05]), female gender (OR = 1.50 [0.72–0.88]), and cardiovascular risk factors were associated with a higher in-hospital mortality risk in diabetes. Compared to non-diabetes patients, the ones with diabetes were younger and had more comorbidities. Unexpectedly, the adjusted risks of in-hospital mortality (aOR = 0.88 [0.76–0.91]), ventricular fibrillation (aOR = 0.79 [0.71–0.88]) and atrial fibrillation (aOR 0.80 [0.76–0.85]) were lower in patients with diabetes, but not cardiogenic shock (aOR 1.01 [0.80–1.27]). However, the length of stay was higher in patients with diabetes, and so were the total charges per stay.Conclusion: In total, we observed a temporal increase in diabetes prevalence among patients with HF and HCM. However, diabetes was paradoxically associated with lower in-hospital mortality and arrhythmias.

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Impact of type 2 diabetes mellitus on mid-term mortality for hypertrophic cardiomyopathy patients who underwent septal myectomy

Cited by 8 publications

References 27 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?

Impact of comorbidities on atrial fibrillation and sudden cardiac death in hypertrophic cardiomyopathy

Diabetes outcomes in heart failure patients with hypertrophic cardiomyopathy

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