Mortality and Morbidity in HF r EF, HF mr EF, and HF p EF Patients with Diabetes in the Middle East

• Published in: Oman medical journal 2020-01, Vol.35 (1), p.e99
• Main Authors: Al-Jarallah, Mohammed, Rajan, Rajesh, Al-Zakwani, Ibrahim, Dashti, Raja, Bulbanat, Bassam, Ridha, Mustafa, Sulaiman, Kadhim, Alsheikh-Ali, Alawi A, Panduranga, Prashanth, AlHabib, Khalid F, Al Suwaidi, Jassim, Al-Mahmeed, Wael, AlFaleh, Hussam, Elasfar, Abdelfatah, Al-Motarreb, Ahmed, Bazargani, Nooshin, Asaad, Nidal, Amin, Haitham
• Format: Article
• Language: English
• ISSN: 1999-768X
• DOI: 10.5001/omj.2020.17

We sought to estimate the mortality and morbidity in diabetic acute heart failure (AHF) patients stratified by left ventricular ejection fraction. We analyzed the data of patients with AHF from seven Middle Eastern countries (Bahrain, Oman, Yemen, Kuwait, UAE, Qatar, and Saudi Arabia) from February to November 2012, who were enrolled in a multinational registry of patients with heart failure (HF). A total of 2258 AHF patients had diabetes mellitus. The mean age was 63.0±11.0 years (ranging from 18 to 99 years), and 60.3% (n = 1362) of the patients were males. The mean ejection fraction (EF) was 37.0±13.0%. HF with reduced EF (< 40%) (HF EF) was observed in 1268 patients (56.2%), whereas 515 patients (22.8%) had mid-range (40-49%) (HF EF) and 475 patients (21.0%) had preserved EF ( 50%) (HF EF). The overall cumulative all-cause mortalities at three- and 12-months follow-up were 11.8% (n = 266) and 20.7% (n = 467), respectively. Those with HF EF were associated with lower three-months cumulative all-cause mortality compared to those with HF EF (7.6% vs. 5.9%; adjusted odds ratio (aOR) = 0.54, 95% confidence interval (CI): 0.31-0.95; 0.031), but not significantly different when compared to those with HF EF (aOR = 0.86, 95% CI: 0.53-1.40; 0.554). There were largely no significant differences among the groups with regards to the 12-months all-cause cumulative mortality (11% vs. 11% vs. 10%; 0.984). There were also no significant differences in re-hospitalization rates between the three HF groups not only at three months (23% vs. 20% vs. 22%; 0.520), but at one-year follow-up (28% vs. 30% vs. 32%; 0.335). Three-month cumulative all-cause mortality was high in diabetic HF EF patients when compared to those with HF EF. However, there were no significant differences in mortality at one-year follow-up between the HF groups. There were also no significant differences in re-hospitalization rates between the HF groups not only at three months but also at one-year follow-up in the Middle East.