Panchal Kajal, Lawson Claire A, Shabnam Sharmin, Khunti Kamlesh, Zaccardi Francesco
Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester, UK.
Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Diabetes Obes Metab. 2025 Jul;27(7):3848-3857. doi: 10.1111/dom.16413. Epub 2025 May 2.
To investigate the association between type 2 diabetes and all-cause mortality in people with ischaemic and non-ischaemic heart failure (HF).
Using the Clinical Practice Research Datalink primary care data, linked to hospital and mortality records, we identified newly diagnosed adults with type 2 diabetes between 2000 and 2021 and matched to up to four people without diabetes by sex, year of birth and general practice. We defined incident HF events as ischaemic if they followed an ischaemic heart disease event; otherwise, as non-ischaemic. We calculated sex-specific incidence rates and hazard ratios (HRs, adjusted for sociodemographic and clinical confounders) for all-cause mortality following HF diagnosis, comparing people with type 2 diabetes to those without diabetes.
In 73 344 people with HF (18 296 [24.9%] with ischaemic HF), 9584 and 31 800 deaths occurred in those with ischaemic and non-ischaemic HF, respectively. Age-standardised mortality rates following ischaemic HF were higher in people with type 2 diabetes (19.2 [95% CI: 18.1-20.3] and 20.4 [19.5-21.4] per 100 person-years in women and men, respectively) compared to those without diabetes (15.1 [14.4-15.8] and 16.5 [15.9-17.1], respectively). Corresponding rates in those with non-ischaemic HF were: 19.5 (19.0-20.1), 22.0 (21.4-22.6), 16.6 (16.2-17.0) and 19.4 (18.9-19.8). The HR for mortality was similar among HF types and between men and women: for ischaemic HF, 1.26 (1.17-1.36) in women and 1.23 (1.15-1.31) in men; for non-ischaemic HF, 1.24 (1.19-1.29) and 1.20 (1.15-1.25), respectively.
Our findings indicate broadly similar mortality rates in people with ischaemic and non-ischaemic HF, with higher rates in people with type 2 diabetes compared to those without diabetes in both women and men.
研究2型糖尿病与缺血性和非缺血性心力衰竭（HF）患者全因死亡率之间的关联。
利用临床实践研究数据链的初级保健数据，并与医院和死亡率记录相链接，我们确定了2000年至2021年间新诊断的2型糖尿病成年患者，并按性别、出生年份和全科医疗情况与多达四名无糖尿病患者进行匹配。如果HF事件继发于缺血性心脏病事件，我们将其定义为缺血性事件；否则定义为非缺血性事件。我们计算了HF诊断后全因死亡率的性别特异性发病率和风险比（HRs，针对社会人口统计学和临床混杂因素进行了调整），比较了2型糖尿病患者和无糖尿病患者。
在73344例HF患者中（18296例[24.9%]为缺血性HF），缺血性和非缺血性HF患者分别有9584例和31800例死亡。与无糖尿病患者相比，2型糖尿病患者缺血性HF后的年龄标准化死亡率更高（女性和男性每100人年分别为19.2[95%CI：18.1-20.3]和20.4[19.5-21.4]）（分别为15.1[14.4-15.8]和16.5[15.9-17.1]）。非缺血性HF患者的相应比率为：19.5（19.0-20.1）、22.0（21.4-22.6）、16.6（16.2-17.0）和19.4（18.9-19.8）。HF类型之间以及男性和女性之间的死亡HR相似：对于缺血性HF，女性为1.26（1.17-1.36），男性为1.23（1.15-1.31）；对于非缺血性HF，分别为1.24（1.19-1.29）和1.20（1.15-1.25）。
我们的研究结果表明，缺血性和非缺血性HF患者的死亡率大致相似，2型糖尿病患者的死亡率高于无糖尿病的男性和女性。
