Chen Ching-Pei, Chien Szu-Chi, Kor Chew-Teng, Hsu Che-Ming
Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Ann Med. 2025 Dec;57(1):2514088. doi: 10.1080/07853890.2025.2514088. Epub 2025 Jun 5.
Diabetes mellitus (DM) is a common comorbidity in heart failure (HF), but the impact of new-onset DM on HF outcomes remains unclear. This study evaluated the effects of DM status on hospitalization for HF (HHF), major adverse cardiac events (MACEs), and mortality in HF patients.
We conducted a retrospective cohort study of patients newly diagnosed HF at Changhua Christian Hospital, Taiwan, from 2011 to 2021. Patients were grouped as non-DM ( = 1477), preexisting DM ( = 1488), and new-onset DM ( = 328). Inverse propensity score weighting was applied to balance covariates.
Compared to the non-DM group, the preexisting DM was associated with higher risks of HHF [hazard ratio (HR), 1.13; 95% confidence interval (CI), 1.02-1.25], MACEs (HR, 1.22; 95% CI, 1.00-1.49), all-cause mortality (HR, 1.17; 95% CI, 1.01-1.36), and cardiovascular death (HR, 1.54; 95% CI, 1.15-2.06). The new-onset DM group showed a significantly higher risk of HHF (HR, 1.24; 95% CI, 1.01-1.51) and MACEs (HR, 1.22; 95% CI, 1.00-1.49), with nonsignificant trends toward increased all-cause mortality (HR, 1.08; 95% CI, 0.79-1.48) and cardiovascular death (HR, 1.36; 95% CI, 0.74-2.48).
In HF patients, preexisting DM is associated with worse outcomes across multiple endpoints. New-onset DM also elevates risks of HHF and MACE, though its effect on mortality is less clear. Although our study, utilizing electronic medical record data, revealed a different pattern compared to the Danish registry, the findings emphasize the need for individualized management strategies based on DM status in HF care.
糖尿病（DM）是心力衰竭（HF）常见的合并症，但新发糖尿病对心力衰竭预后的影响仍不明确。本研究评估了糖尿病状态对心力衰竭患者因心力衰竭住院（HHF）、主要不良心脏事件（MACE）和死亡率的影响。
我们对2011年至2021年在台湾彰化基督教医院新诊断为心力衰竭的患者进行了一项回顾性队列研究。患者分为非糖尿病组（n = 1477）、既往糖尿病组（n = 1488）和新发糖尿病组（n = 328）。应用逆倾向评分加权来平衡协变量。
与非糖尿病组相比，既往糖尿病组发生HHF的风险更高[风险比（HR），1.13；95%置信区间（CI），1.02 - 1.25]、MACE（HR，1.22；95% CI，1.00 - 1.49）、全因死亡率（HR，1.17；95% CI，1.01 - 1.36）和心血管死亡（HR，1.54；95% CI，1.15 - 2.06）。新发糖尿病组发生HHF（HR，1.24；95% CI，1.01 - 1.51）和MACE（HR，1.22；95% CI，1.00 - 1.49）的风险显著更高，全因死亡率（HR，1.08；95% CI，0.79 - 1.48）和心血管死亡（HR，1.36；95% CI，0.74 - 2.48）呈非显著上升趋势。
在心力衰竭患者中，既往糖尿病与多个终点的不良预后相关。新发糖尿病也会增加HHF和MACE的风险，尽管其对死亡率的影响尚不清楚。尽管我们利用电子病历数据的研究与丹麦登记处的结果不同，但研究结果强调了在心力衰竭治疗中基于糖尿病状态制定个体化管理策略的必要性。
