978-P: Prevalence of Diabetic Cardiomyopathy in Adults with Diabetes or Prediabetes and Its Association with the Risk of Overt Heart Failure: A Multicohort Analysis

Abstract

Introduction: Diabetic cardiomyopathy (DbCM) is characterized by abnormalities in cardiac structure or function in the absence of cardiovascular (CV) disease. The prevalence of DbCM and its independent contribution to the risk of heart failure (HF) among community-dwelling individuals with prediabetes or diabetes (Pre-DM/DM) is not well known. Methods: Adults without prevalent CAD or HF were pooled from 3 community-based cohort studies (ARIC, CHS, and CRIC cohorts). Presence of DbCM in patients with Pre-DM/DM was defined by elevated NT-proBNP levels (>125 in normal/overweight or >100 pg/mL in obese) plus either ≥1 or ≥2 echocardiographic abnormalities (left atrial enlargement, left ventricle hypertrophy, diastolic dysfunction). The DbCM definition with ≥2 echo abnormalities was used for the primary analysis and the cohort was stratified into three groups: euglycemia, pre-DM/DM without DbCM, and pre-DM/DM with DbCM. Kaplan-Meier and Cox models adjusted for demographics, CV risk factors, and kidney function were used to evaluate the risk of overt HF across the study groups. Results: The study included 10,208 individuals, of which 6,852 had pre-DM/DM. The prevalence DbCM in the overall cohort was 6.6% and 19.5% based on the presence of ≥2 or ≥1 echocardiographic abnormalities with elevated NT-proBNP levels. Over 10-year follow up, individuals with pre-DM/DM had a higher risk for overt HF than euglycemic individuals (10.1% vs. 6.4%). Among individuals with pre-DM/DM, presence of DbCM identified a higher risk subset of individuals with significantly greater risk for developing overt HF as compared with pre-DM/DM without DbCM in unadjusted (19.6% vs. 9.1%) as well as adjusted analysis (HR [95% CI] pre-DM/DM without DbCM = 1.32 [1.12-1.55], pre-DM/DM with DbCM = 2.28 [1.81-2.86], ref: euglycemia). Conclusions: Presence of DbCM in individuals with pre-DM/DM identifies a high-risk subgroup for development of overt HF. Disclosure M. W. Segar: None. K. Patel: None. N. Kondamudi: None. A. Pandey: None. Funding Applied Therapeutics