title: Impact of new-onset diabetes mellitus and glycemic control on the prognosis of heart failure patients: a propensity-matched study in the community.
abstract: OBJECTIVE
  To assess the incidence of type 2 diabetes mellitus (DM) in patients with heart failure (HF), and to evaluate the effect of new-onset DM and glycemic control on the prognosis of HF patients treated with a contemporary medical regimen.
  
  
  METHODS
  Prospective study of 5314 HF patients and previously unknown DM during 9 years. Their mean age was 71.8 ± 7.9 years, 53.0% were women, and 50.2% had non-systolic HF. During a median follow-up of 56.9 ± 18.2 months, 68.9% of the patients died, 88.6% were hospitalized for HF, and 1519 (27.3%) developed new-onset DM. We propensity-matched those 1519 HF patients with DM, with 1519 HF patients non-diagnosed with DM.
  
  
  RESULTS
  The age- and sex-adjusted incidence (per 100 HF patients/years) of DM in HF patients was 3.20, higher in women and in patients with non-systolic HF (p<0.01). Patients with HF and DM and those with a mean HbA1c>7.0% presented an increased mortality (HR of death [CI 95%]: 2.44 [1.68-3.19] and, HR: 2.56 [1.77-3.35], respectively), mainly due to an increased cardiovascular mortality (HR ≥ 2.40 [1.46-3.34]) (P<0.001). The rate of hospitalization, of 30-day readmissions, and the number of visits were higher among HF patients with DM or with HbA1c>7.0% (p<0.001). These relationships of DM and its poor metabolic control with prognosis were maintained, independently of the gender, the type of HF (systolic or, non-systolic), the comorbidities, and the medication used (P<0.01).
  
  
  CONCLUSIONS
  New-onset diabetes mellitus and its poor metabolic control (HbA1c>7.0%) are associated with a increased mortality and morbidity of patients with heart failure.
authors.affiliation: Department of Medicine, Hospital Universitario Puerto Real, Cadiz, Spain.
authors.forename: Sotero P
authors.initials: SP
authors.lastname: Romero
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Egido
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Escobar
authors.forename: Jose L
authors.initials: JL
authors.lastname: Andrey
authors.forename: Ramón
authors.initials: R
authors.lastname: Corzo
authors.forename: Virginia
authors.initials: V
authors.lastname: Perez
authors.forename: Gloria J
authors.initials: GJ
authors.lastname: Garcia-Domiguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Gomez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D057216:Propensity Score; D011446:Prospective Studies; D012111:Residence Characteristics
chemical_list: D001786:Blood Glucose