New research from a global study led by a UConn health physician has found that patients with type-2 diabetes admitted into the hospital for congestive heart failure face a one-in-four chance of dying over the next 18 months.
Principal investigator Dr. William B. White, a professor in the Pat and Jim Calhoun Cardiology Center at UConn Health, said the combination of type-2 diabetes accompanied by an acute coronary syndrome requires more attention to prevent further major cardiac events. His results were presented on June 11 at the American Diabetes Association’s annual meeting in New Orleans, and published online in the ADA journal Diabetes Care.
Patients with type-2 diabetes have two to three times the heart disease risk of the general population, according to the research. This is partly because obesity and other illnesses such as hypertension and elevated cholesterol contribute to both diseases, but there are concerns that some of the medications that help control blood sugar may also damage the heart. Even insulin, a hormone that healthy people make naturally but some patients with type-2 diabetes need as a medication, can contribute to heart disease.
Because of the diabetes-heart disease link, all new diabetes drugs are now required by the U.S. Food and Drug Administration to undergo formal testing for their impact on heart and stroke outcomes.
White, along with colleagues at 898 medical institutions around the world who were investigators in the EXAMINE trial, were testing the diabetes drug alogliptin (Nesina), which is a member of the family of medications known as DPP-4 inhibitors. The researchers recruited 5,380 patients with type-2 diabetes after the patient had a major but nonfatal acute coronary syndrome such as a heart attack, or hospitalization for unstable angina.
People with type-2 diabetes admitted to the hospital for heart failure faced a 24 to 28 percent chance of death during the remainder of the trial, on alogliptin or placebo respectively. That’s more than five times the risk of death seen in the patients who had no additional non-fatal cardiovascular event while in the study.
“It’s a very dramatic result,” White told UConn Today. “A person with type 2 diabetes requiring hospitalization for heart failure in the EXAMINE trial was a harbinger of a very poor outcome.”
