Chen HF, et al. - Using a nationally representative sample from Taiwan’s National Health Insurance (NHI), experts sought to compare patients with type 2 diabetes and non-diabetes subjects in terms of age- and sex-specific risk estimates of heart failure (HF). They also evaluated the risks of HF in association with type 2 diabetes in people with various coronary heart diseases (CHDs). The risk of HF in both men and women, as well as in all age groups, especially in young patients, may be increased with diabetes mellitus. Compared to control subjects with CHD, a similarly increased risk of HF was seen in people with type 2 diabetes without CHD. In patients with type 2 diabetes, they noted certain CHDs (including percutaneous transluminal coronary angiograph, coronary artery bypass surgery, and acute myocardial infraction) greatly increase risk of HF.

Methods

• Authors identified 34,291 patients with type 2 diabetes from ambulatory care claims in 2000; the same number of age- and sex matched controls were randomly selected from the registry of NHI beneficiaries in the same year.
• They linked all study subjects to inpatient claims (2000-2013) to identify the possible admissions for HF.
• The relative hazards of HF in relation to type 2 diabetes according to various age- and sex-stratifications were compared with Cox proportional hazard regression model.
• They also compared the relative hazard of HF between type 2 diabetes and controls with and without past histories of various CHDs and coronary revascularization procedures.

Results

• As per data, compared with control subjects, a significant association of type 2 diabetes with increased hazard of HF [adjusted hazard ratio (aHR): 1.47, 95% confidence interval (CI) 1.40-1.54] was seen.
• Findings suggested that in both genders, the type 2 diabetes aged < 45 years had the highest increased hazard of HF, with an aHR of 2.54 (95% CI 1.62-3.98) and 4.12 (95% CI 2.35-7.23) for men and women, respectively.
• Compared with the control subjects without any CHD, increased hazards of HF (aHR: 1.54, 95% CI 1.41-1.68 in men and aHR: 1.56, 95% CI 1.43-1.71 in women) was seen in type 2 diabetes patients without prior CHD had, which were comparable to figures of the same-sex non-diabetes who had histories of heart diseases (aHR: 1.60 and 1.55 for men and women, respectively).