Impact of diabetes mellitus on the outcomes of subjects with hypertrophic cardiomyopathy: A nationwide cohort study

• Published in: Diabetes research and clinical practice Vol. 186; p. 109838
• Main Authors: Lee, Hyun-Jung, Kim, Hyung-Kwan, Kim, Bong-Seong, Han, Kyung-Do, Rhee, Tae-Min, Park, Jun-Bean, Lee, Heesun, Lee, Seung-Pyo, Kim, Yong-Jin
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2022
• Subjects: Aged; Atrial Fibrillation - complications; Cardiomyopathy, Hypertrophic - complications; Cardiomyopathy, Hypertrophic - epidemiology; Cohort Studies; Diabetes Complications; Diabetes mellitus; Diabetes Mellitus - epidemiology; Diabetic Cardiomyopathies; Female; Heart failure; Heart Failure - etiology; Humans; Hypertrophic cardiomyopathy; Kidney Failure, Chronic - complications; Male; Middle Aged; Outcomes; Risk Factors; Heart failure; Hypertrophic cardiomyopathy; Diabetic Cardiomyopathies; Diabetes Complications; Diabetes mellitus; Outcomes
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2022.109838

•The clinical impact of ageing-related diseases such as diabetes is becoming increasingly important in HCM.•A nationwide cohort of 9,883 subjects with HCM.•Diabetes is associated with 3.5-fold higher risk of end-stage renal failure in HCM.•Diabetes is associated with 15% higher risk of heart failure in HCM.•Insulin-treated diabetes patients are at highest risk. Diabetes mellitus (DM) often coexists in elderly hypertrophic cardiomyopathy (HCM) patients; however, its impact on clinical outcomes is unclear. We compared clinical outcomes according to the presence of DM in a nationwide HCM cohort. In 9,883 HCM subjects (mean age 58.5 ± 13.1, men 71.7%), 1,327 (13.4%) had DM. During follow-up (mean 5.9 ± 2.5 years), end-stage renal disease (ESRD) progression, coronary events (myocardial infarction, coronary revascularization), heart failure (HF), cardiovascular mortality, and all-cause mortality occurred in 80 (0.8%), 365 (3.7%), 1,558 (15.8%), 354 (3.6%), and 877 (8.9%) subjects, respectively. DM HCM subjects had significantly higher risks of ESRD progression (HR 3.49, 95% CI 2.20–5.54) and HF (HR 1.15, 95% CI 1.01–1.32) compared to non-DM HCM subjects, independent of age, sex, ischemic heart disease, atrial fibrillation, and other comorbidities. There was a tendency for greater risk of ESRD progression, HF, and all-cause death in subjects with more advanced stage of DM (p-for-trend < 0.05 for all). Insulin-treated DM was associated with the highest risk. DM HCM subjects have higher risk of ESRD progression and HF. Considering the extended life expectancy of HCM and increasing number of elderly HCM subjects, active surveillance and management of DM-related outcomes should be highlighted.