TY - JOUR
T1 - Temporal trends and factors associated with diabetes mellitus among patients hospitalized with heart failure
T2 - Findings from Get With The Guidelines–Heart Failure registry
AU - Echouffo-Tcheugui, Justin B.
AU - Xu, Haolin
AU - DeVore, Adam D.
AU - Schulte, Phillip J.
AU - Butler, Javed
AU - Yancy, Clyde W.
AU - Bhatt, Deepak L.
AU - Hernandez, Adrian F.
AU - Heidenreich, Paul A.
AU - Fonarow, Gregg C.
N1 - Funding Information:
Dr Fonarow reports significant consulting for Novartis and modest consulting for Amgen, Bayer, Gambro, Medtronic, and Janssen; Dr Fonarow is a member of the GWTG Steering Committee. Dr Fonarow holds the Eliot Corday Chair of Cardiovascular Medicine at UCLA and is also supported by the Ahmanson Foundation (Los Angeles, California).
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden. Methods Using data from the Get With the Guidelines–Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40% ≤ EF < 50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015. Logistic regression was used to assess whether in-hospital outcomes and HF quality of care were related to trends. Results Among 364,480 HF hospitalizations, 160,171 had diabetes (44.0% overall, 41.8% in HFrEF, 46.7% in HFbEF, 45.5% in HFpEF). There was a temporal increase in diabetes frequency in HF patients (43.2%-45.8%; Ptrend < .0001), including among those with HFrEF (42.0%-43.6%; Ptrend < .0001), HFbEF (46.0%-49.2%; Ptrend < .0001), or HFpEF (43.6%-46.8%, Ptrend < .0001). Diabetic patients had a longer hospital stay (adjusted odds ratio 1.14, 95% CI 1.12-1.16), but lower in-hospital mortality (adjusted odds ratio 0.93 [0.89-0.97]) compared with those without diabetes, with limited differences in quality measures. Temporal trends in diabetes were not associated with in-hospital mortality or length of stay. There were no temporal interactions of most HF quality measures with diabetes status. Conclusions Approximately 44% of hospitalized HF patients have diabetes, and this proportion has been increasing over the past 10 years, particularly among those patients with new-onset HFpEF.
AB - Background The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to define this burden. Methods Using data from the Get With the Guidelines–Heart Failure registry, we assessed temporal trends in diabetes prevalence among patients with HF and in subgroups with reduced ejection fraction (HFrEF; EF < 40%), borderline EF (HFbEF; 40% ≤ EF < 50%), or preserved EF (HFpEF; EF ≥ 50%), hospitalized between 2005 and 2015. Logistic regression was used to assess whether in-hospital outcomes and HF quality of care were related to trends. Results Among 364,480 HF hospitalizations, 160,171 had diabetes (44.0% overall, 41.8% in HFrEF, 46.7% in HFbEF, 45.5% in HFpEF). There was a temporal increase in diabetes frequency in HF patients (43.2%-45.8%; Ptrend < .0001), including among those with HFrEF (42.0%-43.6%; Ptrend < .0001), HFbEF (46.0%-49.2%; Ptrend < .0001), or HFpEF (43.6%-46.8%, Ptrend < .0001). Diabetic patients had a longer hospital stay (adjusted odds ratio 1.14, 95% CI 1.12-1.16), but lower in-hospital mortality (adjusted odds ratio 0.93 [0.89-0.97]) compared with those without diabetes, with limited differences in quality measures. Temporal trends in diabetes were not associated with in-hospital mortality or length of stay. There were no temporal interactions of most HF quality measures with diabetes status. Conclusions Approximately 44% of hospitalized HF patients have diabetes, and this proportion has been increasing over the past 10 years, particularly among those patients with new-onset HFpEF.
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U2 - 10.1016/j.ahj.2016.07.025
DO - 10.1016/j.ahj.2016.07.025
M3 - Article
C2 - 27914505
AN - SCOPUS:84988458382
SN - 0002-8703
VL - 182
SP - 9
EP - 20
JO - American heart journal
JF - American heart journal
ER -