Al-Jarallah Mohammed, Rajan Rajesh, Al-Zakwani Ibrahim, Dashti Raja, Bulbanat Bassam, Ridha Mustafa, Sulaiman Kadhim, Alsheikh-Ali Alawi A, Panduranga Prashanth, AlHabib Khalid F, Al Suwaidi Jassim, Al-Mahmeed Wael, AlFaleh Hussam, Elasfar Abdelfatah, Al-Motarreb Ahmed, Bazargani Nooshin, Asaad Nidal, Amin Haitham
Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al-Amiri Hospital, Kuwait City, Kuwait.
Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman and Gulf Health Research, Muscat, Oman.
Oman Med J. 2020 Feb 18;35(1):e99. doi: 10.5001/omj.2020.17. eCollection 2020 Jan.
We sought to estimate the mortality and morbidity in diabetic acute heart failure (AHF) patients stratified by left ventricular ejection fraction.
We analyzed the data of patients with AHF from seven Middle Eastern countries (Bahrain, Oman, Yemen, Kuwait, UAE, Qatar, and Saudi Arabia) from February to November 2012, who were enrolled in a multinational registry of patients with heart failure (HF).
A total of 2258 AHF patients had diabetes mellitus. The mean age was 63.0±11.0 years (ranging from 18 to 99 years), and 60.3% (n = 1362) of the patients were males. The mean ejection fraction (EF) was 37.0±13.0%. HF with reduced EF (< 40%) (HFEF) was observed in 1268 patients (56.2%), whereas 515 patients (22.8%) had mid-range (40-49%) (HFEF) and 475 patients (21.0%) had preserved EF ( 50%) (HFEF). The overall cumulative all-cause mortalities at three- and 12-months follow-up were 11.8% (n = 266) and 20.7% (n = 467), respectively. Those with HFEF were associated with lower three-months cumulative all-cause mortality compared to those with HFEF (7.6% vs. 5.9%; adjusted odds ratio (aOR) = 0.54, 95% confidence interval (CI): 0.31-0.95; 0.031), but not significantly different when compared to those with HFEF (aOR = 0.86, 95% CI: 0.53-1.40; 0.554). There were largely no significant differences among the groups with regards to the 12-months all-cause cumulative mortality (11% vs. 11% vs. 10%; 0.984). There were also no significant differences in re-hospitalization rates between the three HF groups not only at three months (23% vs. 20% vs. 22%; 0.520), but at one-year follow-up (28% vs. 30% vs. 32%; 0.335).
Three-month cumulative all-cause mortality was high in diabetic HFEF patients when compared to those with HFEF. However, there were no significant differences in mortality at one-year follow-up between the HF groups. There were also no significant differences in re-hospitalization rates between the HF groups not only at three months but also at one-year follow-up in the Middle East.
我们试图评估按左心室射血分数分层的糖尿病急性心力衰竭（AHF）患者的死亡率和发病率。
我们分析了2012年2月至11月来自七个中东国家（巴林、阿曼、也门、科威特、阿联酋、卡塔尔和沙特阿拉伯）的AHF患者的数据，这些患者被纳入了一项心力衰竭（HF）患者的多国登记研究。
共有2258例AHF患者患有糖尿病。平均年龄为63.0±11.0岁（范围为18至99岁），60.3%（n = 1362）的患者为男性。平均射血分数（EF）为37.0±13.0%。射血分数降低（<40%）的心力衰竭（HFEF）患者有1268例（56.2%），而515例（22.8%）患者的射血分数处于中等范围（40 - 49%）（HFEF），475例（21.0%）患者的射血分数保留（≥50%）（HFEF）。在3个月和12个月随访时的总体全因累积死亡率分别为11.8%（n = 266）和20.7%（n = 467）。与射血分数保留的心力衰竭（HFEF）患者相比，射血分数降低的心力衰竭（HFEF）患者3个月累积全因死亡率较低（7.6%对5.9%；调整后的优势比（aOR）= 0.54，95%置信区间（CI）：0.31 - 0.95；P = 0.031），但与射血分数处于中等范围的心力衰竭（HFEF）患者相比无显著差异（aOR = 0.86，95% CI：0.53 - 1.40；P = 0.554）。在12个月全因累积死亡率方面，各亚组之间总体无显著差异（11%对11%对10%；P = 0.984）。三个心力衰竭亚组之间的再住院率不仅在3个月时无显著差异（23%对20%对22%；P = 0.520），在1年随访时也无显著差异（28%对30%对32%；P = 0.335）。
与射血分数保留的心力衰竭（HFEF）患者相比，糖尿病射血分数降低的心力衰竭（HFEF）患者3个月累积全因死亡率较高。然而，在1年随访时，各心力衰竭亚组之间的死亡率无显著差异。在中东地区，各心力衰竭亚组之间的再住院率不仅在3个月时无显著差异，在1年随访时也无显著差异。
