Hospitalization, Death in Heart Failure Modified by HbA1c
Stratification of T2D by HbA1c shows U-shaped associations for first hospitalization and mortality.
(HealthDay News) -- For patients with heart failure, the risks conferred by type 2 diabetes (T2D) can be stratified by glycemic control and drug treatments, according to a study published online in JACC: Heart Failure.
Claire A. Lawson, PhD, RN, from the University of Keele in the United Kingdom, and colleagues compared patients with versus those without T2D for risk of all-cause first hospitalization and death in an incident heart failure database cohort. T2D was stratified by categories of hemoglobin A1c (HbA1c) or drug treatments.
The researchers found that T2D was associated with the risk of first hospitalization and mortality in heart failure (adjusted odds ratios [aORs], 1.29 and 1.24, respectively). Compared with the reference heart failure group without T2D, stratification of T2D by HbA1c levels showed U-shaped associations with both outcomes. The highest-risk categories were HbA1c >9.5% and <5.5% (aORs: hospitalization, 1.75 and 1.42; mortality, 1.3 and 1.29, respectively). There was a correlation for T2D group with change in HbA1c of >1% decrease with hospitalization and mortality (aORs, 1.33 and 1.36). T2D group with reducing drug treatments were associated with hospitalization and mortality (aORs, 2.13 and 2.09).
"In the general HF [heart failure] population, T2D stratified by glycemic control and drug treatments showed differential risk associations," the authors write. "Routine measures of dynamic diabetes status provide important prognostic indication of poor outcomes in HF."
Lawson CA, Jones PW, Teece L, et al. Association Between Type 2 Diabetes and All-Cause Hospitalization and Mortality in the UK General Heart Failure Population Stratification by Diabetic Glycemic Control and Medication Intensification. JACC Heart Fail. doi:10.1016/j.jchf.2017.08.020