Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain.
Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain.
Expert Rev Endocrinol Metab. 2024 Sep;19(5):447-457. doi: 10.1080/17446651.2024.2365769. Epub 2024 Jun 12.
To assess 20-year time trends in the prevalence of diabetes mellitus (DM) among inpatients with heart failure (HF) and the influence of coexisting DM and kidney disease (KD) on outcomes.
A retrospective study of patients was admitted due to HF, during the period 2000/2019. The period of follow-up was divided into three intervals according to the European Medical Agency approval of newer hypoglycemic drugs. We analyzed in-hospital mortality and outcomes during the follow-up period.
A total of 4959 patients were included. Over time, prevalence of DM was significantly raising among women with HF (50 to 53.2%) and descending among men (50% to 46.8%, = 0.02). Total mortality and readmissions were higher in patients with DM during the and second periods. However, no significant differences were found in the third-one (HR 1.14, 95% CI 0.94-1.39, = 0.181). A protector role of oral hypoglycemic medications was observed in this last period. According to the presence of KD, the patients with both DM and KD were who presented most of the events.
Over the time analyzed, the prevalence of DM raised among women and decreased among men. DM influenced the prognosis of HF except in the third period when more protective hypoglycemic drugs started to be used.
评估 20 年来心力衰竭（HF）住院患者中糖尿病（DM）的患病率，并评估共存的 DM 和肾脏疾病（KD）对结局的影响。
本研究回顾性分析了 2000 年至 2019 年期间因 HF 入院的患者。随访期间根据欧洲药品管理局批准的新型降糖药物将时间分为三个时间段。我们分析了住院期间的死亡率和随访期间的结局。
共纳入 4959 例患者。随着时间的推移，女性 HF 患者中 DM 的患病率显著升高（50%至 53.2%， = 0.02），男性 HF 患者中 DM 的患病率则下降（50%至 46.8%）。在第二和第三时间段，DM 患者的总死亡率和再入院率更高。然而，在第三个时间段未发现显著差异（HR 1.14，95%CI 0.94-1.39， = 0.181）。在这最后一个时间段，口服降糖药物具有保护作用。根据 KD 的存在，DM 和 KD 并存的患者发生了最多的事件。
在分析的时间内，女性 DM 的患病率上升，而男性则下降。DM 影响 HF 的预后，除了在第三个时间段开始使用更多具有保护作用的降糖药物时。
