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Pàgina inicial > Articles > Articles publicats > Effect of insulin on readmission for heart failure following a hospitalization for acute heart failure |
Data: | 2020 |
Resum: | 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 1 year readmission for HF in patients discharged for acute HF. 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 1 year readmission for HF in patients discharged after acute HF. Participants' mean age was 73. 4 ± 11. 2 years, 50. 8% were women, 44. 7% had T2DM [including 527 (18. 2%) on insulin therapy], and 52. 7% had preserved ejection fraction. At 1 year 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 1 year mortality. After multivariable adjustment, patients on insulin were at significantly higher risk of 1 year 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). 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. |
Ajuts: | Ministerio de Economía y Competitividad PIE15/00013 Ministerio de Economía y Competitividad CB16/11/00420 Ministerio de Economía y Competitividad CB16/11/00403 |
Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. |
Llengua: | Anglès |
Document: | Article ; recerca ; Versió publicada |
Matèria: | Insulin therapy ; Type 2 diabetes mellitus ; Acute heart failure ; Hospital readmission |
Publicat a: | ESC Heart Failure, Vol. 7 (august 2020) , p. 3320-3328, ISSN 2055-5822 |
9 p, 2.0 MB |