Physicians' Academy for Cardiovascular Education

HF development after T2DM diagnosis associated with highest 5-year risk of death

Type 2 Diabetes Mellitus and Impact of Heart Failure on Prognosis Compared to Other Cardiovascular Diseases: A Nationwide Study

Literature - Zareini B, Blanche P, D'Souza M et al., - Circ Cardiovasc Qual Outcomes. 2020. doi: 10.1161/CIRCOUTCOMES.119.006260.

Introduction and methods

Observational studies in patients with T2DM have reported increased rates of mortality following myocardial infarction, stroke, chronic kidney disease (CKD) and heart failure (HF) [1-11]. However, the risk profile among real-life patients with newly diagnosed T2DM who develop CV and renal disease remains unknown [12,13]. Moreover, the prognostic importance in terms of mortality risk of CV and renal diagnoses in T2DM patients is still uncertain. This nationwide study estimated the absolute 5-year risk of death, the 5-year risk ratio (RR) of death and decrease in lifespan in patients with newly diagnosed T2DM who developed HF, ischemic heart disease (IHD), stroke, CKD, or peripheral artery disease (PAD) after diagnosis of T2DM.

Data were collected from 4 nationwide Danish registers: The Danish National Patient Registry, The Danish National Prescription Registry, The Danish Cause of Death Registry and The Danish Civil registry. A total of 153,405 patients with newly diagnosed T2DM between 1998 and 2015 and with no prior CV or renal diagnoses were included.

The primary outcome was all-cause death. Patients were followed until the end of the study period (December 31, 2015), death or emigration. Median follow-up was 9.7 years (IQR 5.8-13.9 years).

Main results


Among patients with newly diagnosed T2DM, those who developed HF alone or in combination with stroke, CKD or PAD had the highest 5-year absolute and relative risk of death and the greatest decrease in lifespan when compared with development of other (combinations of) CV and renal diseases.


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