Influence of diabetes mellitus on prognosis of elderly patients with heart failure with preserved ejection fraction and construction of prognosis prediction model

Objective To explore the influence of diabetes on the prognosis of elderly patients with heart failure with preserved ejection fraction (HFpEF), and to construct a nomogram model to predict the prognosis of elderly patients with HFpEF. Methods A total of 115 elderly patients with HFpEF admitted to Anqing First People's Hospital from January 2020 to January 2023 were selected retrospectively and divided into poor prognosis group (40 cases) and good prognosis group (75 cases) according to whether the patients had major cardiovascular adverse events (MACE) within one year. The clinicl data were collected. Logistic regression was used to analyze the influencing factors of MACE in elderly patients with HFpEF, and nomogram prediction model was constructed. Results Logistic regression analysis showed that diabetes mellitus, New York Heart Association (NYHA) grade Ⅲ-Ⅳ, high N-terminal pro-brain natriuretic peptide (NT-proBNP) and low geriatric nutritional risk index (GNRI) were the risk factors of poor prognosis in elderly patients with HFpEF (P＜0.05). Hosmer-Lemeshow goodness-of-fit test results showed that the model had a high goodness-of-fit (χ2=6.694, P=0.570) and good predictive performance ［an area under the receiver operating characteristic curve was 0.936 (95%CI: 0.894 to 0.977), with a sensitivity of 87.50% and a specificity of 85.33%］. Conclusion Comorbid diabetes, NYHA grade Ⅲ-Ⅳ, high NT-proBNP and low GNRI are the risk factors of MACE in elderly patients with HFpEF within one year, and the nomogram model has a certain predictive value for the prognosis of elderly patients with HFpEF.