• LoridoJosé Carlos ArévaloJCAInternal Medicine Department, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz. Spain. Electronic address: joscarlor@gmx.es., GómezJuana CarreteroJCInternal Medicine Department, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz. Spain., Miriam Romero Correa, Jesus Recio Iglesias, Teresa Choucino Fernández, Rosa Jordana Camajuncosa, Margarita Carrera Izquierdo, Carlos Jiménez Guardiola, Lucía Fuentes Pardo, Esther Piniella Ruiz, Francesc Formiga, and BautistaPrado SalamancaPSInternal Medicine Department, Hospital Universitario Virgen Macarena, Calle Dr. Fedriani, 3, 41009 Sevilla..
• Internal Medicine Department, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz. Spain. Electronic address: joscarlor@gmx.es.
• Eur. J. Intern. Med. 2022 Oct 1; 104: 59-65.

AimThis work aims to compare the characteristics of advanced heart failure (HF) in patients with and without type 2 diabetes mellitus (DM) and to determine the relevance of variables used to define advanced HF.Patients And MethodsThis cross-sectional, multicenter study included patients hospitalized for HF. They were classified into four groups according to presence/absence of advanced HF, determined based on general and cardiac criteria, and presence/absence of DM. To analyze the importance of variables, we grew a random forest algorithm (RF) based on mortality at six months.ResultsA total of 3153 patients were included. The prevalence of advanced HF among patients with DM was 24% compared to 23% among those without DM (p=0.53). Patients with advanced HF and DM had more comorbidity related to cardiovascular and renal diseases; their prognosis was the poorest (log-rank <0.0001) though the adjusted hazard ratio by group in the Cox regression analysis was not significant. The variables that were significantly related to mortality were the number of comorbidities (p=0.005) and systolic blood pressure (p=0.024). The RF showed that general criteria were more important for defining advanced HF than cardiac criteria.ConclusionsPatients with advanced HF and DM were characterized by DM in progression with macro and microvascular complications. The outcomes among advanced HF patients were poor; patients with advanced HF and DM had the poorest outcomes. General criteria were the most important to establish accurately a definition of advanced HF, being decisive the evidence of disease progression in patients with DM.Copyright © 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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