Absence of interaction of diabetes mellitus with chronic kidney disease on mortality in acute heart failure

Figures & data

Table 1. Descriptive characteristics of our whole population admitted for heart failure (HF) and stratified by chronic kidney disease (CKD) and diabetes mellitus (DM) status.

	HF, global N = 275,176	HF/CKD N = 25,174	HF/non-CKD N = 250,002	p-Value (CKD vs. non-CKD)	HF/DM N = 88,994	HF/non-DM N = 186,182	p-Value (DM vs. non-DM)
Age in years, mean ± SD	76.2 ± 12.8	78.4 ± 10.1	76.0 ± 13.1	<0.001	76.3 ± 9.6	76.2 ± 14.2	0.067
Male sex, %	47.9	54.5	47.2	<0.001	44.3	49.5	<0.001
Hypertension, %	37.3	34.1	37.7	<0.001	44.9	33.7	<0.001
Diabetes mellitus, %	32.3	40.2	31.6	<0.001	NA	NA	NA
Chronic kidney disease	9.1	NA	NA	NA	11.4	8.1	<0.001
Obesity, %	11.9	9.3	12.2	<0.001	17.5	9.3	<0.001
Hypercholesterolemia, %	15.1	14.4	15.2	0.001	22.7	11.5	<0.001
Smokers, %	7.4	3.5	7.7	<0.001	5.7	8.1	<0.001
Atrial fibrillation, %	40.4	41.2	40.4	0.010	40.6	40.4	0.329
Coronary artery disease, %	19.1	25.3	18.5	<0.001	24.4	16.5	<0.001
Heart valve disease, %	8.9	9.0	8.9	0.561	8.3	9.1	<0.001
Acute respiratory failure, %	42.4	28.4	43.9	<0.001	36.0	45.4	<0.001
Anemia, %	14.9	27.9	13.6	<0.001	17.0	13.8	<0.001
Charlson Comorbidity Index > 2, %^a	31.1	35.8	28.1	<0.001	26.7	21.9	<0.001
Hospitalization days, mean ± SD	8.9 ± 7.9	9.9 ± 9.0	8.8 ± 7.8	<0.001	9.2 ± 7.9	8.7 ± 7.9	<0.001
Mortality rate, %	10.4	14.1	10.0	<0.001	9.2	11.0	<0.001

Notes: HF, heart failure; CKD, chronic kidney disease; DM, diabetes mellitus; SD, standard deviation; and

^aModified Comorbidity Charlson Indexes exclude CKD when comparing CKD versus non-CKD patients and DM when comparing DM versus non-DM patients.

p Values <0.05 denote statistical significance.

Table 2. Crude mortality rates for patients admitted for acute decompensated heart failure (HF) according to prevalent chronic kidney disease (CKD) and diabetes mellitus (DM) status.

	DM present	DM absent
CKD present	Total: N = 10,110 Die: N = 1223 (12.1%)	Total: N = 15,064 Die: N = 2328 (15.5%)
CKD absent	Total: N = 78,884 Die: N = 6966 (8.8%)	Total: N = 171,118 Die: N = 18,109 (10.6%)

Notes: DM, diabetes mellitus and CKD, chronic kidney disease.

p Values< 0.001 for all comparisons.

Table 3. Interaction test in a multivariate logistic regression model including pre-specified predictive factors of in-hospital mortality.

	In-hospital mortality
Multivariate model	Odds ratio	95% CI	p Value
Number of subjects	N = 275,176
Sex, male	0.99	0.96–1.01	0.29
Age, years	1.04	1.03–1.04	<0.001
Modified Charlson  Comorbidity Index^a	1.74	1.69–1.79	<0.001
Acute respiratory failure	1.59	1.55–1.63	<0.001
CKD	1.46	1.39–1.53	<0.001
DM	0.85	0.82–0.87	<0.001
CKD-by-DM	1.01	0.94–1.10	0.73

Notes: CI, confidence interval; CKD, chronic kidney disease; DM: diabetes mellitus.

^aModified Charlson Comorbidity Index: it excludes CKD and DM.

p Values <0.05 denote statistical significance.