Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational studyReport as inadecuate

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Cardiovascular Diabetology

, 10:39

First Online: 14 May 2011Received: 30 March 2011Accepted: 14 May 2011


BackgroundPatients with type 2 diabetes mellitus and heart failure have adverse clinical outcomes, but the characteristics and prognosis of those with undiagnosed diabetes in this setting has not been established.

MethodsIn total, 400 patients admitted consecutively with acute heart failure were grouped in three glycaemic categories: no diabetes, clinical diabetes previously reported or with hypoglycaemic treatment and undiagnosed diabetes. The latter was defined by the presence of at least two measurements of fasting plasma glycaemia ≥ 7 mmol-L before or after the acute episode.Group differences were tested by proportional hazards models in all-cause and cardiovascular mortality during a 7-year follow-up.

ResultsThere were 188 47% patients without diabetes, 149 37% with clinical diabetes and 63 16% with undiagnosed diabetes. Patients with undiagnosed diabetes had a lower prevalence of hypertension, dyslipidaemia, peripheral vascular disease and previous myocardial infarction than those with clinical diabetes and similar to that of those without diabetes. The adjusted hazards ratios for 7-year total and cardiovascular mortality compared with the group of subjects without diabetes were 1.69 95% CI: 1.17-2.46 and 2.45 95% CI: 1.58-3.81 for those with undiagnosed diabetes, and 1.48 95% CI: 1.10-1.99 and 2.01 95% CI: 1.40-2.89 for those with clinical diabetes.

ConclusionsUndiagnosed diabetes is common in patients requiring hospitalization for acute heart failure. Patients with undiagnosed diabetes, despite having a lower cardiovascular risk profile than those with clinical diabetes, show a similar increased mortality.

Keywordsacute heart failure diabetes cardiovascular mortality undiagnosed diabetes List of AbbreviationsACEAngiotensin converting enzyme

CIconfidence interval

HbA1cglycosylated hemoglobin

ICDInternational classification of diseases

SDstandard deviation.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-10-39 contains supplementary material, which is available to authorized users.

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Author: Juana A Flores-Le Roux - Josep Comin - Juan Pedro-Botet - David Benaiges - Jaume Puig-de Dou - Juan J Chillarón - Alberto


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