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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BMC
2025-04-01
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| Series: | Diabetology & Metabolic Syndrome |
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| 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. |
| format | Article |
| id | doaj-art-9bcb773a46104ea4a3724e1ebc22a251 |
| institution | DOAJ |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| 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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