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Prognostic impact of diabetes mellitus in patients with heart failure according to the etiology of left ventricular systolic dysfunction

Daniel L. Dries, MD, MPH^*, Nancy K. Sweitzer, MD, PhD, Mark H. Drazner, MD^*, Lynne W. Stevenson, MD and Bernard J. Gersh, MB, DPhil

^* Heart Failure Research Group and D. W. Reynolds Cardiovascular Research Center, Division of Cardiology, University of Texas Southwestern Medical School, Dallas, Texas, USA
Division of Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

View larger version (9K): [in a new window]   Figure 1 Survival free from all-cause mortality in the three cohorts in the Studies Of Left Ventricular Dysfunction (SOLVD) Prevention trial. The patients with ischemic cardiomyopathy and diabetes (n = 575; dashed line) had increased mortality compared with the patients with ischemic cardiomyopathy and no diabetes (n = 3,086; solid line) (p < 0.0001 by log-rank), but not significantly greater than that of the patients with nonischemic cardiomyopathy (n = 562; dotted line) (p = 0.21 by log-rank). The cohort with ischemic cardiomyopathy without diabetes (n = 3,086; solid line) demonstrated significantly lower mortality compared with the nonischemic cohort (p = 0.007 by log-rank) and the ischemic cohort with diabetes.

View larger version (10K): [in a new window]   Figure 2 Survival free from all-cause mortality in the three cohorts in the Studies Of Left Ventricular Dysfunction (SOLVD) Treatment trial. The patients with ischemic cardiomyopathy and diabetes (n = 534; dashed line) had increased mortality compared with the patients with ischemic cardiomyopathy without diabetes (n = 1,392; solid line) and patients with nonischemic cardiomyopathy (n = 642; dotted line) (p < 0.0001 log-rank for both comparisons.) There was no significant difference in survival between the patients with ischemic cardiomyopathy without diabetes and the patients with nonischemic cardiomyopathy.