Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study

Abstract Background Type 2 diabetes mellitus (T2DM) is known to worsen the prognosis of heart failure (HF), but its specific impact on patients with ischemic versus non-ischemic heart failure with mildly reduced ejection fraction (HFmrEF) remains unclear due to limited research and conflicting evide...

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Main Authors: Zhican Liu, Hailong Hu, Jianping Zeng, Mingyan Jiang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Diabetology & Metabolic Syndrome
Subjects:
Online Access:https://doi.org/10.1186/s13098-025-01627-6
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author Zhican Liu
Hailong Hu
Jianping Zeng
Mingyan Jiang
author_facet Zhican Liu
Hailong Hu
Jianping Zeng
Mingyan Jiang
author_sort Zhican Liu
collection DOAJ
description Abstract Background Type 2 diabetes mellitus (T2DM) is known to worsen the prognosis of heart failure (HF), but its specific impact on patients with ischemic versus non-ischemic heart failure with mildly reduced ejection fraction (HFmrEF) remains unclear due to limited research and conflicting evidence. Methods We conducted a retrospective study of 1,691 HFmrEF patients at Xiangtan Central Hospital. Participants were divided into four groups: ischemic with T2DM (467 patients), ischemic without T2DM (856 patients), non-ischemic with T2DM (87 patients), and non-ischemic without T2DM (281 patients). We utilized the Cox proportional hazards model to analyze differences in all-cause mortality and cardiovascular events among the groups. Results After adjusting for multiple confounding factors using the Cox proportional hazards model, the ischemic heart disease and T2DM group had a significantly higher risk of all-cause mortality compared to the ischemic group without T2DM (HR = 1.5, 95% CI = 1.2–1.9, P = 0.001). The risk of cardiovascular events was also significantly increased (HR = 1.3, 95% CI = 1.1–1.5, P = 0.001). In non-ischemic HFmrEF patients, T2DM was not associated with a significantly increased risk of all-cause mortality (HR = 1.0, 95% CI = 0.6–1.7, P = 0.957) or cardiovascular events (HR = 1.3, 95% CI = 0.9–1.9, P = 0.113). Conclusion T2DM significantly increases the risk of all-cause mortality and cardiovascular events in ischemic HFmrEF patients, while its impact on non-ischemic HFmrEF patients is limited. These findings underscore the importance of managing T2DM in patients with ischemic HFmrEF.
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spelling doaj-art-9bcb773a46104ea4a3724e1ebc22a2512025-08-20T03:07:43ZengBMCDiabetology & Metabolic Syndrome1758-59962025-04-0117111610.1186/s13098-025-01627-6Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort studyZhican Liu0Hailong Hu1Jianping Zeng2Mingyan Jiang3Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, The Affiliated Hospital of Hunan UniversityDepartment of Cardiology, Xiangtan Central Hospital, The Affiliated Hospital of Hunan UniversityDepartment of Cardiology, Xiangtan Central Hospital, The Affiliated Hospital of Hunan UniversityDepartment of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, The Affiliated Hospital of Hunan UniversityAbstract Background Type 2 diabetes mellitus (T2DM) is known to worsen the prognosis of heart failure (HF), but its specific impact on patients with ischemic versus non-ischemic heart failure with mildly reduced ejection fraction (HFmrEF) remains unclear due to limited research and conflicting evidence. Methods We conducted a retrospective study of 1,691 HFmrEF patients at Xiangtan Central Hospital. Participants were divided into four groups: ischemic with T2DM (467 patients), ischemic without T2DM (856 patients), non-ischemic with T2DM (87 patients), and non-ischemic without T2DM (281 patients). We utilized the Cox proportional hazards model to analyze differences in all-cause mortality and cardiovascular events among the groups. Results After adjusting for multiple confounding factors using the Cox proportional hazards model, the ischemic heart disease and T2DM group had a significantly higher risk of all-cause mortality compared to the ischemic group without T2DM (HR = 1.5, 95% CI = 1.2–1.9, P = 0.001). The risk of cardiovascular events was also significantly increased (HR = 1.3, 95% CI = 1.1–1.5, P = 0.001). In non-ischemic HFmrEF patients, T2DM was not associated with a significantly increased risk of all-cause mortality (HR = 1.0, 95% CI = 0.6–1.7, P = 0.957) or cardiovascular events (HR = 1.3, 95% CI = 0.9–1.9, P = 0.113). Conclusion T2DM significantly increases the risk of all-cause mortality and cardiovascular events in ischemic HFmrEF patients, while its impact on non-ischemic HFmrEF patients is limited. These findings underscore the importance of managing T2DM in patients with ischemic HFmrEF.https://doi.org/10.1186/s13098-025-01627-6Type 2 diabetes Mellitus (T2DM)Heart failure with mildly reduced ejection fraction (HFmrEF)IschemicAll cause deathCardiovascular events
spellingShingle Zhican Liu
Hailong Hu
Jianping Zeng
Mingyan Jiang
Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
Diabetology & Metabolic Syndrome
Type 2 diabetes Mellitus (T2DM)
Heart failure with mildly reduced ejection fraction (HFmrEF)
Ischemic
All cause death
Cardiovascular events
title Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
title_full Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
title_fullStr Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
title_full_unstemmed Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
title_short Type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic HFmrEF patients: a retrospective cohort study
title_sort type 2 diabetes increases the risk of mortality and cardiovascular events in ischemic hfmref patients a retrospective cohort study
topic Type 2 diabetes Mellitus (T2DM)
Heart failure with mildly reduced ejection fraction (HFmrEF)
Ischemic
All cause death
Cardiovascular events
url https://doi.org/10.1186/s13098-025-01627-6
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