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Observational Study
. 2018 Sep 10;17(1):125.
doi: 10.1186/s12933-018-0768-y.

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

Kathrin Weidner  1   2 , Michael Behnes  3   4 , Tobias Schupp  1   2 , Jonas Rusnak  1   2 , Linda Reiser  1   2 , Armin Bollow  1   2 , Gabriel Taton  1   2 , Thomas Reichelt  1   2 , Dominik Ellguth  1   2 , Niko Engelke  1   2 , Jorge Hoppner  5 , Ibrahim El-Battrawy  1   2 , Kambis Mashayekhi  6 , Christel Weiß  7 , Martin Borggrefe  1   2 , Ibrahim Akin  1   2
Affiliations
Observational Study

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

Kathrin Weidner et al. Cardiovasc Diabetol. .

Abstract

Objectives: The study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission.

Background: Data regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited.

Methods: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. "after discharge") and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years.

Results: In 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias.

Conclusion: Presence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission.

Keywords: Death; Diabetes; Mortality; Prognosis; Sudden cardiac death; Ventricular tachyarrhythmias.

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Figures

Fig. 1
Fig. 1
Kaplan Meier survival curves demonstrating higher long-term all-cause mortality before (left panel) and after propensity score matching (right panel) in diabetics presenting with ventricular tachyarrhythmias
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