Influence of Diabetes Mellitus Interactions With Cardiovascular Risk Factors on Post-Myocardial Infarction Heart Failure Hospitalizations

Authors

Srikanth Yandrapalli, Division of Cardiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA. Electronic address: syandrapalli@mgh.harvard.edu.
Aaqib H. Malik, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Fnu Namrata, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Gayatri Pemmasani, Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Dhrubajyoti Bandyopadhyay, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Saraschandra Vallabhajosyula, Section of Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Wilbert S. Aronow, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
William H. Frishman, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Diwakar Jain, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Howard A. Cooper, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Julio A. Panza, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.ijcard.2021.11.086

Journal Title

International Journal of Cardiology

First Page

140

Last Page

146

Document Type

Article

Publication Date

2-1-2022

Department

Medicine

Abstract

OBJECTIVE: There is a paucity of information regarding how cardiovascular risk factors (RF) modulate the impact of diabetes mellitus (DM) on the heart failure hospitalization (HFH) risk following an acute myocardial infarction (AMI). METHODS: Adult survivors of an AMI were retrospectively identified from the 2014 US Nationwide Readmissions Database. The impact of DM on the risk for a 6-month HFH was studied in subgroups of RFs using multivariable logistic regression to adjust for baseline risk differences. Individual interactions of DM with RFs were tested. RESULTS: Of 237,549 AMI survivors, 37.2% patients had DM. Primary outcome occurred in 12,934 patients (5.4%), at a 106% higher rate in DM patients (7.9% vs 4.0%, p < 0.001), which was attenuated to a 45% higher adjusted risk. Higher HFH risk in DM patients was consistent across subgroups and significant interactions were present between DM and other RFs. The increased HFH risk with DM was more pronounced in patients without certain HF RFs compared with those with these RFs [age < 65: OR for DM 1.84 (1.58-2.13) vs age ≥ 65: OR 1.34 (1.24-1.45); HF absent during index AMI: OR for DM 1.87 (1.66-2.10) vs HF present: OR 1.24 (1.14-1.34); atrial fibrillation absent: OR for DM 1.57 (1.46-1.68) vs present: OR 1.19 (1.06-1.33); P < 0.001 for all]. Similar results were noted for hypertension and chronic kidney disease. CONCLUSIONS: AMI survivors with DM had a higher risk of 6-month HFHs. The impact of DM on the increased HFH risk was more pronounced in patients without certain RFs suggesting that more aggressive preventive strategies related to DM and HF are needed in these subgroups to prevent or delay the onset of HFHs.

Recommended Citation

Yandrapalli, S., Malik, A. H., Namrata, F., Pemmasani, G., Bandyopadhyay, D., Vallabhajosyula, S., Aronow, W. S., Frishman, W. H., Jain, D., Cooper, H. A., & Panza, J. A. (2022). Influence of Diabetes Mellitus Interactions With Cardiovascular Risk Factors on Post-Myocardial Infarction Heart Failure Hospitalizations. International Journal of Cardiology, 348, 140-146. https://doi.org/10.1016/j.ijcard.2021.11.086