Impact of diabetes on the current in-hospital management of heart failure. From the TEMISTOCLE study.
BACKGROUND
Little is known about the clinical profile, use of resources, management and outcome of a large population of diabetic patients with heart failure managed in a community setting.


METHODS
A prospective cross-sectional survey in the setting of acute hospital admissions for heart failure to 167 cardiology and 250 internal medicine departments between February 14 and 25, 2000.


RESULTS
Among the 2127 consecutively admitted patients, 603 (28.4%) had a history of diabetes; they were significantly younger, had a lower rate of atrial fibrillation, and a more frequent ischemic etiology than non-diabetics. Just as non-diabetic patients, diabetics underwent invasive and non-invasive procedures in a low percentage of cases, even though slightly more frequently when managed by cardiologists. Diabetic patients were less frequently prescribed amiodarone and anticoagulants, and more frequently prescribed nitrates and antiplatelets. The all-cause in-hospital mortality rate was similar among diabetics and non-diabetics (5.3 vs 5.7%, p = NS). Adjusted analysis confirmed that diabetes is not independently associated with a worse outcome.


CONCLUSIONS
In a community setting diabetes per se has only a slight impact on the management and outcome of patients with heart failure.
Opasich
Cristina
C
Department of Cardiology, Salvatore Maugeri Foundation, Pavia, Italy.
Cafiero
Massimo
M
Scherillo
Marino
M
De Feo
Stefania
S
Caputo
Francesco
F
Gonzini
Lucio
L
Lavecchia
Rinaldo
R
Loru
Franco
F
Maggioni
Aldo P
AP
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome