Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure

Background 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.Methods We...

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Main Authors: Ching-Pei Chen, Szu-Chi Chien, Chew-Teng Kor, Che-Ming Hsu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2514088
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author Ching-Pei Chen
Szu-Chi Chien
Chew-Teng Kor
Che-Ming Hsu
author_facet Ching-Pei Chen
Szu-Chi Chien
Chew-Teng Kor
Che-Ming Hsu
author_sort Ching-Pei Chen
collection DOAJ
description Background 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.Methods 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 (n = 1477), preexisting DM (n = 1488), and new-onset DM (n = 328). Inverse propensity score weighting was applied to balance covariates.Results 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).Conclusion 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.
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spelling doaj-art-3fcfb5e111de47bf9ea138acf796669f2025-08-20T03:24:36ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2514088Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failureChing-Pei Chen0Szu-Chi Chien1Chew-Teng Kor2Che-Ming Hsu3Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDivision of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanGraduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, TaiwanBackground 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.Methods 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 (n = 1477), preexisting DM (n = 1488), and new-onset DM (n = 328). Inverse propensity score weighting was applied to balance covariates.Results 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).Conclusion 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.https://www.tandfonline.com/doi/10.1080/07853890.2025.2514088Heart failurehospitalization for heart failuremajor adverse cardiac eventsmortalitydiabetes Mellitusinverse propensity score weighting
spellingShingle Ching-Pei Chen
Szu-Chi Chien
Chew-Teng Kor
Che-Ming Hsu
Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
Annals of Medicine
Heart failure
hospitalization for heart failure
major adverse cardiac events
mortality
diabetes Mellitus
inverse propensity score weighting
title Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
title_full Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
title_fullStr Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
title_full_unstemmed Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
title_short Effects of preexisting and new-onset diabetes mellitus on clinical outcomes of patients with heart failure
title_sort effects of preexisting and new onset diabetes mellitus on clinical outcomes of patients with heart failure
topic Heart failure
hospitalization for heart failure
major adverse cardiac events
mortality
diabetes Mellitus
inverse propensity score weighting
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2514088
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