English abstract
Objectives: We sought to estimate the mortality and morbidity in diabetic acute heart
failure (AHF) patients stratified by left ventricular ejection fraction. Methods: We
analyzed the data of patients with AHF from seven Middle Eastern countries (Bahrain,
Oman, Yemen, Kuwait, UAE, Qatar, and Saudi Arabia) from February to November
2012, who were enrolled in a multinational registry of patients with heart failure
(HF). Results: A total of 2258 AHF patients had diabetes mellitus. The mean age was
63.0±11.0 years (ranging from 18 to 99 years), and 60.3% (n = 1362) of the patients
were males. The mean ejection fraction (EF) was 37.0±13.0%. HF with reduced EF
(< 40%) (HFrEF) was observed in 1268 patients (56.2%), whereas 515 patients (22.8%)
had mid-range (40–49%) (HFmrEF) and 475 patients (21.0%) had preserved EF
(≥ 50%) (HFpEF). The overall cumulative all-cause mortalities at three- and 12-months
follow-up were 11.8% (n = 266) and 20.7% (n = 467), respectively. Those with HFpEF
were associated with lower three-months cumulative all-cause mortality compared to
those with HFrEF (7.6% vs. 5.9%; adjusted odds ratio (aOR) = 0.54, 95% confidence
interval (CI): 0.31–0.95; p = 0.031), but not significantly different when compared to
those with HFmrEF (aOR = 0.86, 95% CI: 0.53–1.40; p = 0.554). There were largely
no significant differences among the groups with regards to the 12-months all-cause
cumulative mortality (11% vs. 11% vs. 10%; p = 0.984). There were also no significant
differences in re-hospitalization rates between the three HF groups not only at three
months (23% vs. 20% vs. 22%; p = 0.520), but at one-year follow-up (28% vs. 30% vs.
32%; p = 0.335). Conclusions: Three-month cumulative all-cause mortality was high in
diabetic HFrEF patients when compared to those with HFpEF. However, there were no
significant differences in mortality at one-year follow-up between the HF groups. There
were also no significant differences in re-hospitalization rates between the HF groups not
only at three months but also at one-year follow-up in the Middle East.
