Cardiovascular Diabetology (Sep 2018)

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

  • Kathrin Weidner,
  • Michael Behnes,
  • Tobias Schupp,
  • Jonas Rusnak,
  • Linda Reiser,
  • Armin Bollow,
  • Gabriel Taton,
  • Thomas Reichelt,
  • Dominik Ellguth,
  • Niko Engelke,
  • Jorge Hoppner,
  • Ibrahim El-Battrawy,
  • Kambis Mashayekhi,
  • Christel Weiß,
  • Martin Borggrefe,
  • Ibrahim Akin

DOI
https://doi.org/10.1186/s12933-018-0768-y
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 12

Abstract

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Abstract Objectives The study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission. Background Data regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited. Methods A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. “after discharge”) and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years. Results In 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias. Conclusion Presence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission.

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