Impact of diabetes mellitus on survival in South East Asian patients with congestive heart failure due to left ventricular systolic dysfunction

Objective We assessed the impact of diabetes mellitus on survival in South East Asian patients with congestive heart failure. Methods 1668 consecutive patients with chronic heart failure (age 65±13 years, ejection fraction 28±12%, 67% male) were followed up for 36±12months. 837 patients (50.2%) were diabetic and 1076 patients (65%) had ischemic cardiomyopathy. Primary outcome measure was all-cause mortality. Secondary outcome measures were heart failure readmission and the composite end-point. Results There were 223 (13.4%) deaths and 112 (7%) heart failure readmissions. Ischemic cardiomyopathy, renal failure, hypertension, cerebrovascular disease, peripheral vascular disease, and hyperlipidemia were more prevalent in diabetics (all p<0.01). All-cause mortality (17.3% vs 9.4%), heart failure readmission (8.1% vs 5.3%) and the composite end-point (21.9% vs 12.6%) occurred more frequently in diabetics (all p<0.05). Diabetes was an independent predictor of all-cause mortality (OR=1.70, p=0.01), as were ischemic cardiomyopathy (OR=1.85, p=0.01), hypertension (OR=1.78, p=0.01), GFR (OR=0.98, p<0.01), and beta-blocker use (OR=0.55, p<0.01). Conclusions In spite of advances in heart failure treatment, the presence of diabetes mellitus significantly worsens survival in South East Asian patients with congestive heart failure.