In Hospital Mortality in Acute Heart Failure with Idiopathic Cardiomyopathy and Type II Diabetes

Abstract

Abstract Background: Clinical characteristics and outcomes in patients with type 2 diabetes mellitus (T2DM) and acute heart failure (AHF) patients with idiopathic cardiomyopathy are not well known. Objective: The objective of our study is to determine all-cause mortality in patients with idiopathic cardiomyopathy presenting with AHF. Methods: We analyzed the data from 509 consecutive patients with idiopathic cardiomyopathy presenting with AHF to 47 hospitals in seven Middle Eastern countries (Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain) between February and November 2012. All patients were stratified according to T2DM. The analyses were performed using the univariate and multivariate statistical techniques. Results: The mean age of the cohort was 52.0 ± 14.8 years. Of the 509 patients, 123 (24.2%) had T2DM and had a higher incidence of major stroke than the nondiabetic group (11.4% vs. 2.8%; P = 0.001). Diabetic patients were also more likely to be associated with hypertension than those without diabetes mellitus (78.9% vs. 21.8%; P < 0.001). Multivariate logistic regression demonstrated that those with cardiogenic shock (adjusted odds ratio [aOR], 59.3; 95% confidence interval [CI]: 20.1–207; P = 0.001) and noninvasive ventilation (NIV) (aOR: 4.19; 95% CI: 1.33–13.1; P = 0.013) were associated with higher odds of all-cause in-hospital mortality. However, age (aOR: 1.00; 95% CI: 0.96–1.03; P = 0.792), T2DM status (aOR: 0.43; 95% CI: 0.10–1.51; P = 0.207), and atrial fibrillation (aOR: 3.95; 95% CI: 0.82–17.2; P = 0.07) were not associated with higher odds of all-cause inhospital mortality. Conclusions: In AHF patients with idiopathic cardiomyopathy, T2DM was not associated with higher odds of all-cause inhospital mortality. Patients on NIV and cardiogenic shock were demonstrated as the independent predictors of increased inhospital mortality.