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Effect of insulin on readmission for heart failure following a hospitalization for acute heart failure.

Fecha de publicación: Fecha Ahead of Print:

Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Bertomeu-Gonzalez, Vicente
  • Facila, Lorenzo
  • Nunez, Eduardo
  • Cordero, Alberto
  • Lupon, Josep
  • Bayes-Genis, Antoni

Grupos y Plataformas de I+D+i

Abstract

AIMS: Type 2 diabetes mellitus (T2DM) is common in patients with heart failure (HF) and is related with worse outcomes. Insulin treatment is associated with sodium and water retention, weight gain, and hypoglycaemia-all pathophysiological mechanisms related to HF decompensation. This study aimed to evaluate the association between insulin treatment and the risk of 1year readmission for HF in patients discharged for acute HF.; METHODS AND RESULTS: We prospectively included 2895 consecutive patients discharged after an episode of acute HF in a single tertiary hospital. Multivariable Cox regression, adapted for competing events, was used to assess the association between insulin treatment and 1year readmission for HF in patients discharged after acute HF. Participants' mean age was 73.4±11.2years, 50.8% were women, 44.7% had T2DM [including 527 (18.2%) on insulin therapy], and 52.7% had preserved ejection fraction. At 1year follow-up, 518 (17.9%) patients had died and 693 (23.9%) were readmitted for HF. The crude risk of readmission for HF was higher in patients on insulin, with no differences in 1year mortality. After multivariable adjustment, patients on insulin were at significantly higher risk of 1year readmission for HF than patients with diabetes who were not on insulin (hazard ratio 1.28; 95% confidence interval 1.04-1.59, P=0.022) and patients without diabetes (hazard ratio 1.26; 95% confidence interval 1.02-1.55, P=0.035).; CONCLUSION: Following acute HF, patients with T2DM on insulin therapy are at increased risk of readmission for HF. Further studies unravelling the mechanisms behind this association are warranted. © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made

Datos de la publicación

ISSN/ISSNe:
2055-5822, 2055-5822

Esc Heart Failure  WILEY PERIODICALS, INC

Tipo:
Article
Páginas:
3320-3328
PubMed:
32790113

Citas Recibidas en Web of Science: 1

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Keywords

  • Insulin therapy; Type 2 diabetes mellitus; Acute heart failure; Hospital readmission

Campos de Estudio

Financiación

INSTITUTO SALUD CARLOS III (CB16/11/00420)
INSTITUTO SALUD CARLOS III (PIE15/00013)

Proyectos y Estudios Clínicos

A multidisciplinary project to advance in basic mechanisms, diagnosis, prediction, and prevention of cardiac damage in reperfused acute myocardial infarction.

Investigador Principal: VICENT BODÍ PERIS

PIE15/00013 . INSTITUTO SALUD CARLOS III . 2016

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

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