Gender Differences in the Impact of Type 2 Diabetes on Long-Term Mortality in Patients with Heart Failure and Preserved Ejection Fraction

Abstract

Background: Type 2 diabetes (T2D) is frequently present as a comorbid condition in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). Recent investigations have demonstrated that females with diabetes are more susceptible to the development of HF compared to males. Nevertheless, there is a lack of extensive research on the prospects of T2D patients with HF, specifically in relation to gender.

Objective: We examined the varying effect of T2DM on overall mortality in males compared to females with HFpEF following hospitalization for acute HF.

Methods: This prospective study included 266 patients with HFpEF who were admitted to and discharged from our hospital after being diagnosed with acute HF. This study employed a Multivariate Cox regression model to assess the association between gender, T2D, and the risk of long-term overall morbidity. Hazard ratios (HR) were used to express risk estimation.

Results: The average age of the group was 68.3±7.2 years and 151 (56.8%) were female. The prevalence of T2D was comparable between males and females (47.2% vs. 53.7%; p=0.168). Following a median follow-up period of 4.2 years (with an interquartile range of 2.0-7.4 years), 158 (59.4%) patients reported mortality. In females, T2D was associated with a significantly increased risk of death from any cause (HR=2.62; 95% confidence interval, 2.36-3.16; P<0.002). However, in males, there was no significant association between T2D and mortality (HR=2.08; 95% confidence interval, 1.69-2.49; P=0.087).

Conclusions: Following the diagnosis of acute HF in patients with HFpEF, females with T2D had an increased risk of mortality.