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Abstract of the day: The impact of new-onset type 2 diabetes in heart failure

Development of new-onset type 2 diabetes mellitus (T2DM) is known to be common in patients with heart failure (HF), but how does new-onset T2DM affect risk of HF hospitalisation, death and ischaemic events?

Heart Failure

In an Advances in Science presentation, available from today, Doctor Bochra Zareini (Gentofte University Hospital, Copenhagen, Denmark) describes an analysis of outcomes of all patients with HF included in Danish nationwide registers (1998–2016). Five-year absolute risk was analysed for HF hospitalisation, event-free death (not related to HF hospitalisation or ischaemic event) and ischaemic events (myocardial infarction, stroke and peripheral artery disease) in patients with new-onset T2DM, prevalent T2DM and no T2DM.

Of all 139,264 patients with HF analysed, 21% of patients had prevalent T2DM at baseline, while 8% developed new­-onset T2DM after diagnosis of HF. The median duration of time between HF diagnosis and new­-onset T2DM diagnosis was 4.1 years (interquartile range, 1.5–5.8 years).

Absolute 5-year risk of HF hospitalisation was 31.5% with new­-onset T2DM, 33.6% with prevalent T2DM and 30.7% with no T2DM, while absolute 5-year risk of event-­free death was 20.9% with new-­onset T2DM, 18.9% with prevalent T2DM and 18.6% with no T2DM. Absolute 5-year risk of an ischaemic event was 17.9% with new-­onset T2DM, 26.1% with prevalent T2DM and 18.8% with no T2DM.

When the 5­-year risk ratio of experiencing HF hospitalisation or event-­free death vs. an ischaemic event was calculated, the risk was highest with new-onset T2DM at 2.9 (95% confidence interval [CI] 2.8–3.1), and was 2.0 (95% CI 2.0–2.1) with prevalent T2DM and 2.6 (95% CI 2.6–2.7) with no T2DM. Similar results were observed across subgroups based on age, gender and comorbidities.

These findings highlight the high risk of HF hospitalisation and death associated with new-onset T2DM and emphasise the need for optimal treatment of patients with HF who develop T2DM.


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The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.