Patients who have diabetes with cardiomyopathy (DbCM) face an elevated risk of developing heart failure (HF), according to new data published in the Journal of the American College of Cardiology.
The intent of the study was to evaluate the prevalence and prognostic implications of diabetes with (DbCM) among community-dwelling patients.
Researchers examined data from 10,208 patients, focusing on 2,900 who had diabetes. Data came from the ARIC (Atherosclerosis Risk in Communities) study, CHS (Cardiovascular Health Study), and the CRIC (Chronic Renal Insufficiency Cohort) study.
The study focused on a variety of ways to define DbCM. The "least restrictive" definition focused on finding evidence of one echocardiographic abnormality, the "intermediate restrictive" definition focused on finding evidence of more than one echocardiographic abnormality and the "most restrictive" definition focused on elevated N-terminal pro-B-type natriuretic peptide levels and more than one echocardiographic abnormality.
The DbCM rates based on these different definitions were 67%, 20% and 11.7%, respectively.
The five-year cumulative incidence of HF in patients with DbCM was 8.4%, 11.2%, and 12.8%, respectively.
In the analysis, factors associated with a higher risk of DbCM included higher fasting glucose, a greater body mass index, older age and diminished kidney function.
In addition, the risk of HF was higher in patients with DbCM than in patients with euglycemia when using the least or most restrictive definitions of DbCM.
“The present findings have important implications for HF prevention in patients with diabetes,” wrote lead author Matthew W. Segar, MD, a specialist at the University of Texas Southwestern Medical Center in Dallas, and colleges. ”Results from completed studies have demonstrated the efficacy of pharmacotherapies such as sodium-glucose cotransporter 2 inhibitors in lowering HF risk. However, no intervention has specifically targeted patients with DbCM, and the efficacy of therapies such as sodium-glucose cotransporter 2 inhibitors in patients with DbCM is unknown.”
Segar et al. note that data from the study reveals the higher risk of HF in patients with DbCM and emphasizes the need for the creation of effective therapeutic approaches to lower the HF risk in high-risk populations.
“Furthermore, by evaluating the prevalence and prognostic implications of different DbCM definitions, the present study findings provide the framework to develop optimal screening strategies for DbCM as a tool to identify high-risk patients who would benefit the most from therapeutic interventions aimed at halting the progression to incident HF.”
The authors noted that future studies are recommended to evaluate whether targeted prescription of effective therapies in patients with DbCM can lower the risk of HF.
Read the full study here.
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