Compared impact of diabetes on the risk of heart failure from acute myocardial infarction to chronic coronary artery disease

Gilles Lemesle (1, 2, 3) , Etienne Puymirat (4) , Laurent Bonello (5, 6, 7) , Tabassome Simon (2, 8, 9, 10) , Philippe-Gabriel Steg (11, 2) , Jean Ferrières (12) , François Schiele (13) , Laurent Fauchier (14, 15) , Patrick Henry (16, 17) , Guillaume Schurtz (3) , Sandro Ninni (1) , Nicolas Lamblin (18, 19, 20, 21) , Christophe Bauters (21) , Nicolas Danchin (4, 2)

1 RNMCD - Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011
2 FACT - Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials
3 Institut Coeur Poumon [CHU Lille]
4 HEGP - Hôpital Européen Georges Pompidou [APHP]
5 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
6 MARS cardio - Mediterranean Association for Research and Studies in Cardiology
7 Service de cardiologie [Hôpital Nord - APHM]
8 CIC Paris-Est - Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière]
9 UPMC - Unité de recherche Phytopharmacie et Médiateurs Chimiques
10 LBPC (U698) - Hémostase, bio-ingénierie et remodelage cardiovasculaires
11 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
12 Service Cardiologie [CHU Toulouse]
13 EAS - European Atherosclerosis Society [Göteborg, Sweden]
14 CHU Trousseau [Tours]
15 EES - Éducation Éthique Santé EA 7505
16 Hôpital Lariboisière-Fernand-Widal [APHP]
17 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
18 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
19 Université de Lille
20 Institut Pasteur de Lille
21 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167

Aim: We attempted to describe the risk of heart failure (HF) occurrence according to diabetes mellitus (DM) status in patients with coronary artery disease (CAD) over time, from acute myocardial infarction (MI) to the chronic stable phase. Methods: For the acute and subacute MI phases, we analysed the FAST-MI cohort restricted to patients without history of HF (n = 12,473). The analysis on 1-year outcomes after MI was further restricted to patients who were discharged alive and without history of HF and/or HF symptoms during the index hospitalisation for MI (n = 9181). To analyse the chronic phase, we analysed the CORONOR cohort restricted to patients without history of HF (n = 3871). The primary endpoint was HF occurrence according to DM status. We also analysed the composite of all-cause death or HF. Results: Killip-Kimball class ≥II during the index MI hospitalisation was more frequent in DM patients compared to non-DM patients (29% vs. 15.3%, adjusted OR = 1.60). At one year after MI, hospitalisation for HF was more frequent in DM patients (3.3% vs. 1.2%, adjusted HR = 1.73). At the chronic phase (5-year outcomes), hospitalisation for HF was more frequent in DM patients (8.5% vs. 4.3%, adjusted HR = 1.70). Results focusing on the composite endpoint (all-cause death or HF) were consistent. Conclusion: DM was associated with a very constant near 2-fold increase in the risk of HF whatever the presentation of CAD. Avoiding the risk of HF occurrence in CAD patients with DM is critical in daily practice and should be a constant life-long endeavour.

Mots clés: Coronary artery disease; Diabetes mellitus; Heart failure; Myocardial infarction

Domaines: Endocrinologie et métabolisme

Gilles Lemesle, Etienne Puymirat, Laurent Bonello, Tabassome Simon, Philippe-Gabriel Steg, et al.. Compared impact of diabetes on the risk of heart failure from acute myocardial infarction to chronic coronary artery disease. Diabetes & Metabolism, 2022, 48 (1), pp.101265. ⟨10.1016/j.diabet.2021.101265⟩. ⟨hal-04277230⟩