Diabetes mellitus in patients with heart failure and effect modification of risk factors for short-term mortality: An observational study from the Registro Colombiano de Falla Cardíaca (RECOLFACA)

• Published in: Biomedica : revista del Instituto Nacional de Salud Vol. 44; no. Sp. 1; pp. 182 - 197
• Main Authors: Echeverría, Luis Eduardo, Saldarriaga, Clara, Campbell-Quintero, Sebastián, Morales-Rodríguez, Lisbeth Natalia, López-Ponce de León, Juan David, Buitrago, Andrés Felipe, Martínez-Carreño, Erika, Sandoval-Luna, Jorge Alberto, Llamas, Alexis, Moreno-Silgado, Gustavo Adolfo, Vanegas-Eljach, Julián, Murillo-Benítez, Nelson Eduardo, Gómez-Paláu, Ricardo, Rivera-Toquica, Alex Arnulfo, Gómez-Mesa, Juan Esteban, Research Group, Recolfaca
• Format: Journal Article
• Language: English
• Published: Colombia Instituto Nacional de Salud 31-05-2024
• Subjects: Aged; colombia; Colombia - epidemiology; diabetes mellitus; diabetes mellitus, type 2; Diabetes Mellitus, Type 2 - complications; Female; heart failure; Heart Failure - complications; Heart Failure - epidemiology; Heart Failure - mortality; Humans; latin america; Male; Middle Aged; mortality; Original; Proportional Hazards Models; Registries; Risk Factors; Colombia; heart failure; Colombia; risk factors; type 2; mortality; Diabetes Mellitus; Latin America
• ISSN: 0120-4157; 2590-7379
• DOI: 10.7705/biomedica.6951

Heart failure and type 2 diabetes mellitus are critical public health issues.
To characterize the risk factors for mortality in patients with heart failure and type 2 diabetes mellitus from a large registry in Colombia and to evaluate the potential effect modifications by type 2 diabetes mellitus over other risk factors.
Heart failure patients with and without type 2 diabetes mellitus enrolled in the Registro Colombiano de Falla Cardíaca (RECOLFACA) were included. RECOLFACA enrolled adult patients with heart failure diagnosis from 60 medical centers in Colombia during 2017-2019. The primary outcome was all-cause mortality. Survival analysis was performed using adjusted Cox proportional hazard models.
A total of 2514 patients were included, and the prevalence of type 2 diabetes mellitus was 24.7% (n = 620). We found seven independent predictors of short-term mortality for the general cohort, chronic obstructive pulmonary disease, sinus rhythm, triple therapy, nitrates use, statins use, anemia, and hyperkalemia. In the type 2 diabetes mellitus group, only the left ventricle diastolic diameter was an independent mortality predictor (HR = 0.96; 95% CI: 0.93-0.98). There was no evidence of effect modification by type 2 diabetes mellitus on the relationship between any independent predictors and all-cause mortality. However, a significant effect modification by type 2 diabetes mellitus between smoking and mortality was observed.
Patients with type 2 diabetes mellitus had higher mortality risk. Our results also suggest that type 2 diabetes mellitus diagnosis does not modify the effect of the independent risk factors for mortality in heart failure evaluated. However, type 2 diabetes mellitus significantly modify the risk relation between mortality and smoking in patients with heart failure.