Abstract 11000: Cardiovascular Outcomes in Patients with Diabetes and Hypertrophic Cardiomyopathy, Hospitalized for Heart Failure

Abstract

Introduction: Diabetes is a widely prevalent pathology complicating many cardiovascular diseases. Hypothesis: We hypothesized that patients with hypertrophic cardiomyopathy (HCM) hospitalized for heart failure (HF) have a worse outcome in the presence of diabetes. Methods: The National Inpatient Sample (NIS) was analysed to identify records from 2005-2015 of patients hospitalized for HF as a complication of HCM. We assessed the cardiovascular and socio-economic trend of patients with diabetes and HCM hospitalized for HF, and compared them to those without diabetes. Results: Diabetes prevalence increased from 24.8% to 32.7% in all HMC patients hospitalized for HF. In diabetes patients, mean age of patients decreased from 71 ±13 to 67.6 ±14.2 (p<0.01) but hospitalizations increased from 0.2 to 0.5 cases/100 000 US adults (p<0.01) (Figure 1). Mortality, cardiogenic shock, ventricular tachycardia (VTach), atrial fibrillation (AF) decreased with time. Length of stay (LOS) was stable, but charges almost doubled. Age (adjusted OR= 1.04 [1.03-1.05]), female gender (adjusted OR= 1.50 [0.72-0.88]) and the presence of several comorbidities assessed using the Elixhauser score (adjusted OR= 1.09 [1.07-1.11]) predicted a higher risk of mortality in those patients. When compared to non-diabetic patients, diabetes patients were younger and had more comorbidities. Unexpectedly, the risk of mortality (adjusted OR= 0.68 [0.56-0.81]), ventricular tachycardia (adjusted OR= 0.79 [0.72-0.88]), ventricular fibrillation (adjusted OR= 0.28 [0.14-0.56]) and atrial fibrillation (adjusted OR 0.80 [0.76-0.85]) were lower in patients with diabetes. However, LOS was higher in patients with diabetes, so were charges. Conclusions: Diabetes is paradoxically associated with lower mortality and lower rates of complications (namely arrhythmias) in HCM patients hospitalized for HF