Risk Factors of Hospitalization due to Congestive Heart Failure in Type 2 Diabetes Patients at Faculty of Medicine Vajira Hospital, Navamindhradhiraj University

Main Article Content

Charnwat Chuantantikamol
Petch Rawdaree


Background: Currently, the prevalence of congestive heart failure in type 2 diabetes mellitus (T2DM) worldwide is increasing continuously. However, risks and incidence of hospital readmission due to congestive heart failure in T2DM are no conclusion. Therefore, this study aimed to evaluate risks of hospital due to congestive heart failure in T2DM patients.

Methods: A matched case-control study was conducted to discover risks of hospitalization because of congestive heart failure (CHF) in T2DM patients at Vajira Hospital. Clinical and laboratory data from medical record of diabetic patients hospitalized due to CHF, defined as a case, from 1st January, 2560 BE to 31st December, 2561 BE and T2DM patients who had no history of CHF which age and sex matched, defined as a control, were retrieved from hospital database. Univariate and multivariate analysis controlling for confounders were conducted to identify risk factors for hospitalization from CHF.

Results: Among the 180 subjects the average age was 68.38 years and 50% was female. Ninety subjects who had heart failure were recruited as cases (50%) and others 90 subjects without heart failure were in control group. All of the cases were diagnosed congestive heart failure by Framingham criteria. Most of cases had heart failure with preserved ejection fraction (51.9%) and 22.2% were readmission due to heart failure. Risk factors for congestive heart failure in T2DM subjects were Body Mass Index (BMI) (OR = 1.18, 95%CI = 1.03-1.36, p-value = 0.02) but protective factor is statin (OR=0.03, 95%CI = 0.000 -0.71, p-value = 0.03)

Conclusions: The risk of hospitalization for heart failure patients with type 2 diabetes mellitus is BMI and protective factor is statin. There was 22.2% of the subjects readmitted due to CHF and smoking is a risk factor for the readmission.


Download data is not yet available.

Article Details

Original Articles


Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation 2003;108(12):1527-32.

Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Diabetes mellitus, fasting glucose, and risk of causespecific death. N Engl J Med 2011;364(9):829-41.

Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009;119(3):e21-181.

Peterson LR, McKenzie CR, Schaffer JE. Diabetic Cardiovascular Disease: Getting to the Heart of the Matter. J Cardiovasc Transl Res 2012;5(4):436-45.

Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood AW, Grishman A. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol 1972;30(6):595-602.

Bertoni AG, Hundley WG, Massing MW, Bonds DE, Burke GL, Goff DC. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes care 2004;27(3):699-703.

Iribarren C, Karter AJ, Go AS, Ferrara A, Liu JY, Sidney S, et al. Glycemic control and heart failure among adult patients with diabetes. Circulation 2001;103(22):2668-73.

Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive heart failure in type 2 diabetes: prevalence, incidence, and risk factors. Diabetes care 2001;24(9):1614-9.

Tousoulis D, Oikonomou E, Siasos G, Stefanadis C. Diabetes Mellitus and Heart Failure. Eur Cardiol 2014;9(1):37-42.

Yang X, Ma RC, So WY, Kong AP, Ko GT, Ho CS, et al. Development and validation of a risk score for hospitalization for heart failure in patients with Type 2 diabetes mellitus. Cardiovasc Diabetol 2008;7:9.

Delea TE, Edelsberg JS, Hagiwara M, Oster G, Phillips LS. Use of thiazolidinediones and risk of heart failure in people with type 2 diabetes: a retrospective cohort study. Diabetes care 2003;26(11):2983-9.

Singh S, Loke YK, Furberg CD. Thiazolidinediones and heart failure: a teleo-analysis. Diabetes care 2007;30(8):2148-53.

Lago RM, Singh PP, Nesto RW. Congestive heart failure and cardiovascular death in patients with prediabetes and type 2 diabetes given thiazolidinediones: a meta-analysis of randomised clinical trials. Lancet 2007;370(9593):1129-36.

Shekelle PG, Rich MW, Morton SC, Atkinson CS, Tu W, Maglione M, et al. Efficacy of angiotensinconverting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status: a meta-analysis of major clinical trials. J Am Coll Cardiol 2003;41(9):1529-38.

Zelniker TA, Wiviott SD, Raz I, Im K, Goodrich EL, Bonaca MP, et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet 2019;393(10166):31-9.

Palazzuoli A, Ceccarelli E, Ruocco G, Nuti R. Clinical impact of oral antidiabetic medications in heart failure patients. Heart Fail Rev 2018;23(3):325-35.

Mahmood SS, Wang TJ. The epidemiology of congestive heart failure: the Framingham Heart Study perspective. Glob Heart 2013;8(1):77-82.

Ziaeian B, Fonarow GC. The Prevention of Hospital Readmissions in Heart Failure. Prog Cardiovasc Dis 2016;58(4):379-85.

Rosano GM, Vitale C, Seferovic P. Heart Failure in Patients with Diabetes Mellitus. Card Fail Rev 2017;3(1):52-5.

Barzilay JI, Kronmal RA, Gottdiener JS, Smith NL, Burke GL, Tracy R, et al. The association of fasting glucose levels with congestive heart failure in diabetic adults > or =65 years: the Cardiovascular Health Study. J Am Coll Cardiol 2004;43(12):2236-41.

Bauters C, Lamblin N, Mc Fadden EP, Van Belle E, Millaire A, de Groote P. Influence of diabetes mellitus on heart failure risk and outcome. Cardiovasc Diabetol 2003;2:1.

Kishimoto I, Makino H, Ohata Y, Tamanaha T, Tochiya M, Anzai T, et al. Intensity of statin therapy and new hospitalizations for heart failure in patients with type 2 diabetes. BMJ Open Diabetes Res Care 2015;3(1):e000137.

Shaw JA, Cooper ME. Contemporary Management of Heart Failure in Patients With Diabetes. Diabetes Care 2020;43(12):2895.

Rosano GM, Vitale C, Seferovic P. Heart Failure in Patients with Diabetes Mellitus. Card fail rev 2017;3(1):52-5.