Cargando…

Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) is a risk factor for the development of heart failure with reduced ejection fraction (HFrEF). Aims: (1) To describe and compare the clinical characteristics and the use of diagnostic and therapeutic procedures among subjects hospitalized with HFrEF accordi...

Descripción completa

Detalles Bibliográficos
Autores principales: Méndez-Bailón, Manuel, Lorenzo-Villalba, Noel, Jiménez-García, Rodrigo, Hernández-Barrera, Valentin, de Miguel-Yanes, Jose María, de Miguel-Diez, Javier, Muñoz-Rivas, Nuria, Andrès, Emmanuel, Lopez-de-Andrés, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878152/
https://www.ncbi.nlm.nih.gov/pubmed/35207300
http://dx.doi.org/10.3390/jcm11041030
_version_ 1784658594467151872
author Méndez-Bailón, Manuel
Lorenzo-Villalba, Noel
Jiménez-García, Rodrigo
Hernández-Barrera, Valentin
de Miguel-Yanes, Jose María
de Miguel-Diez, Javier
Muñoz-Rivas, Nuria
Andrès, Emmanuel
Lopez-de-Andrés, Ana
author_facet Méndez-Bailón, Manuel
Lorenzo-Villalba, Noel
Jiménez-García, Rodrigo
Hernández-Barrera, Valentin
de Miguel-Yanes, Jose María
de Miguel-Diez, Javier
Muñoz-Rivas, Nuria
Andrès, Emmanuel
Lopez-de-Andrés, Ana
author_sort Méndez-Bailón, Manuel
collection PubMed
description Background: Type 2 diabetes mellitus (T2DM) is a risk factor for the development of heart failure with reduced ejection fraction (HFrEF). Aims: (1) To describe and compare the clinical characteristics and the use of diagnostic and therapeutic procedures among subjects hospitalized with HFrEF according to the presence of type 2 diabetes mellitus (T2DM) and sex; (2) to assess the effect of T2DM and sex on hospital outcomes among the patients hospitalized with HFrEF using propensity score matching (PSM); and (3) to identify which clinical variables were associated to in-hospital mortality (IHM) among the patients hospitalized with HFrEF and T2DM according to their sex. Methods: A retrospective cohort study from 2016 to 2019 using the Spanish National Hospital Discharge Database was conducted. The diagnosis and procedures were codified with the International Classification of Disease 10th version (ICD10). Subjects aged ≥ 40 with a primary diagnosis of HFrEF were included. We included those patients with a diagnosis of T2DM in any diagnosis position. The descriptive statistics used were total and relative frequencies (percentages), means with standard deviations, and medians with an interquartile range. To control the effect of confounding variables when T2DM patients and non-T2DM patients were compared, we matched the cohorts using PSM. Multivariable logistic regression models were used to identify which study variables independently affected the IHM among men and women with HF and T2DM. Also, this multivariable method was applied for sensitivity analyses to confirm the results of the PSM. Results: A total of 28,894 patients were included. T2DM was present in 39.59%. Women with T2DM more frequently had atrial fibrillation, valvular heart disease, anemia, dementia, depression, and hyponatremia than men with T2DM. However, men had more coronary heart disease, chronic renal disease, COPD, and obstructive sleep apnea. All the procedures were significantly more commonly used among men than women. Blood transfusion was the only procedure more frequently identified among women with T2DM. For the sensitivity analysis in patients with T2DM hospitalized with HFrEF, we confirmed the results of the PSM, finding that women had a 14% higher risk of dying in the hospital than men (OR 1.14; 95% CI 1.01–1.35). Obesity seemed to have a protective effect (OR 0.85; 95% CI 0.73–0.98) on the in-hospital morality. Conclusions: Subjects with diabetes are admitted for HFrEF and have a greater number of comorbidities than non-diabetics. Diabetic women have a higher mortality rate than men with diabetes and all the procedures evaluated were significantly more often used among men than women.
format Online
Article
Text
id pubmed-8878152
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88781522022-02-26 Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus Méndez-Bailón, Manuel Lorenzo-Villalba, Noel Jiménez-García, Rodrigo Hernández-Barrera, Valentin de Miguel-Yanes, Jose María de Miguel-Diez, Javier Muñoz-Rivas, Nuria Andrès, Emmanuel Lopez-de-Andrés, Ana J Clin Med Article Background: Type 2 diabetes mellitus (T2DM) is a risk factor for the development of heart failure with reduced ejection fraction (HFrEF). Aims: (1) To describe and compare the clinical characteristics and the use of diagnostic and therapeutic procedures among subjects hospitalized with HFrEF according to the presence of type 2 diabetes mellitus (T2DM) and sex; (2) to assess the effect of T2DM and sex on hospital outcomes among the patients hospitalized with HFrEF using propensity score matching (PSM); and (3) to identify which clinical variables were associated to in-hospital mortality (IHM) among the patients hospitalized with HFrEF and T2DM according to their sex. Methods: A retrospective cohort study from 2016 to 2019 using the Spanish National Hospital Discharge Database was conducted. The diagnosis and procedures were codified with the International Classification of Disease 10th version (ICD10). Subjects aged ≥ 40 with a primary diagnosis of HFrEF were included. We included those patients with a diagnosis of T2DM in any diagnosis position. The descriptive statistics used were total and relative frequencies (percentages), means with standard deviations, and medians with an interquartile range. To control the effect of confounding variables when T2DM patients and non-T2DM patients were compared, we matched the cohorts using PSM. Multivariable logistic regression models were used to identify which study variables independently affected the IHM among men and women with HF and T2DM. Also, this multivariable method was applied for sensitivity analyses to confirm the results of the PSM. Results: A total of 28,894 patients were included. T2DM was present in 39.59%. Women with T2DM more frequently had atrial fibrillation, valvular heart disease, anemia, dementia, depression, and hyponatremia than men with T2DM. However, men had more coronary heart disease, chronic renal disease, COPD, and obstructive sleep apnea. All the procedures were significantly more commonly used among men than women. Blood transfusion was the only procedure more frequently identified among women with T2DM. For the sensitivity analysis in patients with T2DM hospitalized with HFrEF, we confirmed the results of the PSM, finding that women had a 14% higher risk of dying in the hospital than men (OR 1.14; 95% CI 1.01–1.35). Obesity seemed to have a protective effect (OR 0.85; 95% CI 0.73–0.98) on the in-hospital morality. Conclusions: Subjects with diabetes are admitted for HFrEF and have a greater number of comorbidities than non-diabetics. Diabetic women have a higher mortality rate than men with diabetes and all the procedures evaluated were significantly more often used among men than women. MDPI 2022-02-16 /pmc/articles/PMC8878152/ /pubmed/35207300 http://dx.doi.org/10.3390/jcm11041030 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Méndez-Bailón, Manuel
Lorenzo-Villalba, Noel
Jiménez-García, Rodrigo
Hernández-Barrera, Valentin
de Miguel-Yanes, Jose María
de Miguel-Diez, Javier
Muñoz-Rivas, Nuria
Andrès, Emmanuel
Lopez-de-Andrés, Ana
Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title_full Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title_fullStr Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title_full_unstemmed Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title_short Clinical Characteristics, Management, and In-Hospital Mortality in Patients with Heart Failure with Reduced Ejection Fraction According to Sex and the Presence of Type 2 Diabetes Mellitus
title_sort clinical characteristics, management, and in-hospital mortality in patients with heart failure with reduced ejection fraction according to sex and the presence of type 2 diabetes mellitus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878152/
https://www.ncbi.nlm.nih.gov/pubmed/35207300
http://dx.doi.org/10.3390/jcm11041030
work_keys_str_mv AT mendezbailonmanuel clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT lorenzovillalbanoel clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT jimenezgarciarodrigo clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT hernandezbarreravalentin clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT demiguelyanesjosemaria clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT demigueldiezjavier clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT munozrivasnuria clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT andresemmanuel clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus
AT lopezdeandresana clinicalcharacteristicsmanagementandinhospitalmortalityinpatientswithheartfailurewithreducedejectionfractionaccordingtosexandthepresenceoftype2diabetesmellitus