Zhongguo quanke yixue (May 2023)
The Effect of Type 2 Diabetes Mellitus on the Prognosis of Patients with Dilated Cardiomyopathy
Abstract
Background Type 2 diabetes mellitus increases the risk of early onset of cardiovascular disease in patients, which poses a major threat to human health. Exploring the impact of type 2 diabetes mellitus on prognosis of patients with dilated cardiomyopathy is good for patient management. Objective To evaluate the effect of type 2 diabetes mellitus on the prognosis of patients with dilated cardiomyopathy. Methods This study retrospectively analyzed 313 patients with dilated cardiomyopathy who were admitted to the Department of Cardiology in the First Affiliated Hospital of Guangxi Medical University from January 2015 to May 2020. Patients were divided to a diabetic group (n=66) or a non-diabetic group (n=247) according to whether they suffered from type 2 diabetes mellitus. General date and laboratory indices were collected. Follow-up was conducted until December 31, 2021. The primary endpoint was all-cause death. This study used landmark analysis to compare survival rate between these two groups. A multivariate Cox proportional hazards regression model was used to analyze the influencing factors of all-cause mortality in patients with dilated cardiomyopathy. Results Landmark analysis showed that there was no significant difference in one-year survival rate between these two groups (χ2=1.520, P=0.218). After 1 year, the survival rate in the diabetic group was lower than that of the non-diabetic group (χ2=4.414, P=0.036). In the multivariate Cox proportional hazards regression model constructed by piecewise fitting method, systolic blood pressure〔HR=0.965, 95%CI (0.948, 0.982) 〕, N-terminal pro-B-type natriuretic peptide〔HR=9.928, 95%CI (4.791, 20.576) 〕 and β-receptor blocker〔HR=0.317, 95%CI (0.168, 0.598) 〕 were the influencing factors of all-cause mortality in patients with dilated cardiomyopathy within one year (P<0.05), while LVEDD〔HR=1.057, 95%CI (1.028, 1.087) 〕and type 2 diabetes mellitus〔HR=1.756, 95%CI (1.011, 3.050) 〕were influencing factors of all-cause mortality in patients with dilated cardiomyopathy after one year (P<0.05) . Conclusion Type 2 diabetes mellitus was not associated with adverse outcomes in patients with dilated cardiomyopathy at 1 year of follow-up, but was strongly associated with poor outcomes after 1 year in patients with dilated cardiomyopathy.
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