Deciphering mortality risk of diabetes medications in heart failure patients with diabetes mellitus under triple guideline-directed medical therapy

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dc.authoridSahin, Anil/0000-0003-3416-5965
dc.authoridYILMAZ, MEHMET BIRHAN/0000-0002-8169-8628
dc.contributor.authorColluoglu, Inci Tugce
dc.contributor.authorCelik, Ahmet
dc.contributor.authorAta, Naim
dc.contributor.authorUral, Dilek
dc.contributor.authorSahin, Anil
dc.contributor.authorUlgu, Mustafa Mahir
dc.contributor.authorKanik, Emine Arzu
dc.date.accessioned2024-09-29T15:57:15Z
dc.date.available2024-09-29T15:57:15Z
dc.date.issued2024
dc.departmentKarabük Üniversitesien_US
dc.description.abstractBackground: Scientific evidence regarding the impact of different combinations of diabetes medications in heart failure patients with diabetes mellitus (HFwDM) remains limited. Aim: We aimed to investigate the effect of monotherapy and combination therapy for DM on all -cause mortality in HFwDM under triple guideline -directed medical therapy (GDMT). Method: This nationwide retrospective cohort study included adult HFwDM under triple GDMT between January 1, 2016 and December 31, 2022.We collected the data from the National Electronic Database of the Turkish Ministry of Health.We created various combination including different diabetes medications based on the current guidelines for DM.The primary endpoint was all -cause mortality. Results: A total of 321,525 HFwDM under triple GDMT (female:49%, median age:68[61 -75] years) were included. The highest rate of prescribed combination therapy was metformin and sulfonylureas ( n = 55,266). In Cox regression analysis, ins & uuml;lin monotherapy had the highest risk for all -cause mortality (HR:2.25, 95CI%:2.062.45), whereas combination therapy including metformin, SGLT2i, and sulfonylureas provided the most beneficial effect on survival (HR:0.29, 95CI%:0.22 -0.39) when compared to patients not receiving diabetes medication. Among patients taking diabetes medications, the inclusion of SGLT2i demonstrated a survival benefit ( p < 0.05), despite concurrent use of volume -retaining medications such as insulin and thiazolidinediones. Conversely, combinations of diabetes medications without SGLT2i did not demonstrate any survival benefit compared to patients not taking diabetes medication ( p > 0.05). Conclusion: This study underscored the use of SGLT2i as monotherapy or as a part of combination diabetes medications to improve survival among HFwDM, while also highlighting that combinations lacking SGLT2i did not confer any survival benefit.en_US
dc.identifier.doi10.1016/j.ijcard.2024.132109
dc.identifier.issn0167-5273
dc.identifier.issn1874-1754
dc.identifier.pmid38703896en_US
dc.identifier.scopus2-s2.0-85192136408en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1016/j.ijcard.2024.132109
dc.identifier.urihttps://hdl.handle.net/20.500.14619/4705
dc.identifier.volume407en_US
dc.identifier.wosWOS:001239893600001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Ireland Ltden_US
dc.relation.ispartofInternational Journal of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectHeart failureen_US
dc.subjectDiabetes mellitusen_US
dc.subjectDiabetes medicationsen_US
dc.subjectCombination therapy for diabetes mellitusen_US
dc.subjectTriple guideline-directed medical therapyen_US
dc.subjectAll-cause mortalityen_US
dc.titleDeciphering mortality risk of diabetes medications in heart failure patients with diabetes mellitus under triple guideline-directed medical therapyen_US
dc.typeArticleen_US

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