Diabetic Heart Failure: Epidemiology and Prognosis

Objectives: Heart failure (HF) in diabetics is becoming increasingly common and their prognosis has been shown to be less favorable overall. This study sought to describe the epidemiological pattern and prognostic factors of HF in diabetic patients to enhance clinical management. Material and Methods: We conducted a retrospective analytical study of the medical records of diabetic patients hospitalized for HF in the Department of Medicine at the Abidjan Heart Institute between January 1, 2015, and December 31, 2018. The study focused on epidemiological characteristics, clinical outcomes, and prognostic factors. Results: Among the 1,079 patients hospitalized for HF, 249 (23.1%) were diagnosed with diabetes. The average age of these patients was 55.5 ± 15.8 years, with males predominating (63.5%). Most patients lived in urban areas (84%), had a job (62.2%), no health insurance (96.8%), and were hypertensive (51.4%). Patients were admitted with New York Heart Association (NYHA) stages IV (70.7%) or III (29.3%) for global (57.8%) or left-sided (28.5%) HF. A total of 57% of patients required rehospitalization during follow-up. We observed a 12% post-hospital all-cause mortality rate. Predictive factors of mortality were sedentary lifestyle, NYHA stage IV, rhythm disorders, and HF with intermediate ventricular function. Conclusion: Diabetic HF is common and severe, carrying an adverse prognosis with high rates of morbidity and mortality. Collaboration between cardiologists and diabetologists in a prospective multicenter study will help develop strategies to halt the progression from diabetes to HF, or vice versa, thereby lowering associated complications and death rates.