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COMORBIDITIES AND THEIR IMPLICATIONS IN PATIENTS WITH AND WITHOUT TYPE 2 DIABETES MELLITUS AND HEART FAILURE WITH PRESERVED EJECTION FRACTION. FINDINGS FROM THE RICA REGISTRY
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  • José Carlos Arévalo-Lorido,
  • Juana Carretero-Gómez,
  • Ricardo Gomez-Huelgas,
  • Pau Llacer,
  • Luis Manzano,
  • Maria Angustias Quesada Simon,
  • Bernardino Roca,
  • Alvaro Gonzalez Franco,
  • Jose Maria Cepeda,
  • Manuel Montero
José Carlos Arévalo-Lorido
Zafra Hospital County
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Juana Carretero-Gómez
Zafra Hospital County
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Ricardo Gomez-Huelgas
Carlos Haya Hospital
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Pau Llacer
Hospital de Manises
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Luis Manzano
Hospital Universitario Ramón y Cajal
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Maria Angustias Quesada Simon
La Paz University Hospital Cardiology Service
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Bernardino Roca
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Alvaro Gonzalez Franco
HUCA
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Jose Maria Cepeda
Hospital Vega Baja
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Manuel Montero
IMIBIC/Hospital Reina Sofia de Córdoba
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Abstract

AIM: to determine if patients with heart failure and preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM) have a higher comorbidity burden than those without T2DM, if other comorbidities are preferentially associated with T2DM, and if these conditions confer a worse patient prognosis. METHODS AND RESULTS: Cohort study based on the RICA Spanish Heart Failure Registry, a multicenter, prospective registry that enrolls patients admitted for decompensated HF and follows them for 1 year. We selected only patients with HFpEF, classified as having or not having T2DM, and performed an agglomerative hierarchical clustering based on variables such as the presence of arrhythmia, chronic obstructive pulmonary disease, dyslipidemia, liver disease, stroke, dementia, body mass index (BMI), hemoglobin levels, estimated glomerular filtration rate, and systolic blood pressure. 1,934 patients were analyzed: 907 had T2DM (mean age 78.4+/-7.6 years) and 1,027 did not (mean age 81.4+/- 7.6 years). The analysis resulted in 4 clusters in patients with T2DM, and 3 in the reminder. All clusters of patients with T2DM showed higher BMI, and more kidney disease and anemia than those without T2DM. Clusters of patients without T2DM had neither significantly better nor worse outcomes. However, among the T2DM patients, clusters 2, 3 and 4 all had significantly poorer outcomes, the worst being cluster 3 (HR 2.0, 95% CI 1.36-2.93, p=0.001). CONCLUSIONS: Grouping our patients with HFpEF and T2DM into clusters based on comorbidities revealed a greater disease burden and prognostic implications associated with the T2DM phenotype, compared to those without T2DM.

Peer review status:ACCEPTED

20 Apr 2020Submitted to International Journal of Clinical Practice
22 Apr 2020Submission Checks Completed
22 Apr 2020Assigned to Editor
22 Apr 2020Reviewer(s) Assigned
22 May 2020Review(s) Completed, Editorial Evaluation Pending
10 Jun 20201st Revision Received
13 Jun 2020Assigned to Editor
13 Jun 2020Reviewer(s) Assigned
13 Jun 2020Submission Checks Completed
28 Jun 2020Review(s) Completed, Editorial Evaluation Pending
19 Jul 20202nd Revision Received
20 Jul 2020Submission Checks Completed
20 Jul 2020Assigned to Editor
20 Jul 2020Reviewer(s) Assigned
05 Aug 2020Review(s) Completed, Editorial Evaluation Pending
06 Aug 2020Editorial Decision: Accept