A history of diabetes mellitus (DM) predicts mortality in cardiomyopathy patients and is associated with worse outcomes than the actual severity of cardiomyopathy, according to a study published in JACC: Clinical Electrophysiology.

Ankit Medhekar, MD, et al., sought to examine the determinants of all-cause mortality, hospitalizations and cardiac hospitalizations in patients with cardiomyopathy of any etiology, stratified by the severity of myocardial dysfunction. Researchers examined data from patients with cardiomyopathy seen at the Heart and Valve Institute at the University of Pittsburgh Medical Center between 2011 and 2017. The study compared baseline characteristics and outcomes between patients with mild-to-moderate cardiomyopathy (left ventricular ejection fraction (LVEF) between 36% and 50%) and severe cardiomyopathy (LVEF ≤35%).

Researchers examined data from 18,003 patients with cardiomyopathy. Of these patients, 5,966 (33%) had mild-to-moderate LVEF. Over a median follow-up of 3.35 years, 8,037 patients (45%) died and 11,056 (61%) were hospitalized for cardiac reasons. Overall, patients with severe cardiomyopathy were more likely to die than those with mild-moderate cardiomyopathy. However, patients with a history of DM and mild-to-moderate cardiomyopathy had worse survival than patients with severe cardiomyopathy and no DM.

"Our data demonstrate higher all-cause mortality and higher rates of cardiac hospitalizations in cardiomyopathy patients with versus without DM," write the authors. "Importantly, these outcomes were significantly worse in patients with DM and mild-to-moderate cardiomyopathy compared to those without diabetes but with severe cardiomyopathy, suggesting that DM is a stronger predictor of worse outcomes in this population than the actual severity of myocardial dysfunction."

Given the results of the study, the authors suggest that further research should be conducted to assess whether patients with mild-to-moderate cardiomyopathy and DM may benefit from lifesaving therapies, such as an ICD, used in the treatment of patients with severe cardiomyopathy.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Stroke Volume, Ventricular Function, Left, Follow-Up Studies, Cardiomyopathies, Hospital Mortality, Diabetes Mellitus, Hospitalization, Electrophysiology

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