Temporal prevalence and prognostic impact of diabetes mellitus and albuminuria in heart failure with preserved ejection fraction
Authors' conclusion
DM and albuminuria are prevalent in HFpEF at baseline, and re-evaluation one year later still reveals new diagnoses. Both factors are independently associated with adverse outcomes. Albuminuria at any time point remains predictive of adverse outcomes in HFpEF.
Study context
- Population
- Consecutive outpatients diagnosed with heart failure with preserved ejection fraction (HFpEF), March 2015-November 2023; T1D excluded; median age 77 years, 67% female
- Participants
- 332 outpatients
- Exposure
- Glucose metabolism status and albuminuria status
- DM-/ALB-n = 121reference
- DM+ /ALB-n = 106
- DM-/ALB+n = 44
- DM+ /ALB+n = 61
- Outcome
- Composite of:
- HF hospitalizations
- All-cause mortality
- Follow-up
- ≈3 years
Methodological detailsconsecutive patients, single outpatient clinic, multivariable-adjusted Cox regression
- Consecutive patients
- Single outpatient clinic
- Multivariable-adjusted Cox regression
Main finding
As reported in the abstract
HF hospitalization or all-cause mortality
Adjusted hazard ratio (95% CI)
DM+vs DM-baseline DM
1.93(1.25–2.97)
ALB+vs ALB-baseline ALB
1.58(1.04–2.41)
DM+ /ALB+highest risk
2.85(1.57–5.15)
Observational data: associations, not effects.
Further findings
Primary outcome by albuminuria course over 1 year · 3 years — between Persistent albuminuria and Free of albuminuria · across the four groups
P = 0.008
New DM+ and ALB+ incidence at 1-year re-evaluation (in those at risk)
- New DM+ incidence
- 3.9%
- New ALB+ incidence
- 22%
- Changed ALB group vs baseline
- n = 63, 25.2%
- Recovered from albuminuria
- 27 (10.8%)
- Re-evaluated in 250 (75%) patients
Original publication
Temporal prevalence and prognostic impact of diabetes mellitus and albuminuria in heart failure with preserved ejection fraction. Cardiovasc Diabetol. Published 5 April 2025. doi:10.
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