Features of acute decompensation of heart failure in patients with type 2 diabetes mellitus with anemia and latent iron deficiency
https://doi.org/10.21886/2712-8156-2021-2-4-33-42
Abstract
Objective: to assess the contribution of anemia and latent iron deficiency (LID) to the formation of acute decompensation of chronic heart failure (ADHF) in patients with diabetes mellitus (DM) type 2 in history.
Materials and methods: a one‑time screening clinical non‑randomized study was conducted. 98 patients with ADHF were examined according to the criteria for inclusion and non‑inclusion, among which 47 (48%) patients suffered from type 2 DM. Among patients with impaired carbohydrate metabolism, 14 (29.8%) patients had an anemic syndrome verified.
Results: the prevalence of anemia among hospitalized patients with ADHF against the background of type 2 DM was 29.8%, LID without anemia – 51.5%. Anemic syndrome in patients with ADHF and type 2 DM was represented by iron deficiency anemia in 85.7% and anemia of chronic conditions in 14.3% of cases. In 2/3 of the patients, anemia corresponded to moderate severity. The relative risk (RR) of the development of ADHF against the background of type 2 DM and anemia increases by 2.4 times, in the presence of LID – by 2.9 times. The presence of coronary artery disease, myocardial infarction in history, atrial fibrillation with a heart rate of more than 110 beats per minute, renal dysfunction, high activity of nonspecific inflammation were risk factors for the formation of ADHF in patients with type 2 DM and anemia. The presence of left ventricular hypertrophy in patients with anemia increased the RR of the development of ADHF by 1.8 times, the presence of chronic kidney disease – by 1.7 times, with an increase in the excretion of albumin/protein in the urine >30 mg/g – by 5.7 times, with tubular dysfunction – by 2.4 times, with an increase in aortic stiffness – by 3.5 times.
Conclusion: the prevalence of anemia and LID among patients with ADHF and type 2 DM is high. These conditions were risk factors for the development of ADHF and its progression. ADHF in patients with type 2 DM against the background of anemia and LID was characterized by a more severe course, a more pronounced lesion of the target organs.
About the Authors
A. S. Veklich
Academician Ye.A. Wagner Perm State Medical University
Russian Federation
Russian Federation
Andrey S. Veklich,
Perm
N. A. Koziolova
Academician Ye.A. Wagner Perm State Medical University
Russian Federation
Russian Federation
Natalya A. Koziolova, Dr. Ci. (Med.), Prof.,
Perm
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For citations:
Veklich A.S., Koziolova N.A. Features of acute decompensation of heart failure in patients with type 2 diabetes mellitus with anemia and latent iron deficiency. South Russian Journal of Therapeutic Practice. 2021;2(4):33-42. (In Russ.) https://doi.org/10.21886/2712-8156-2021-2-4-33-42
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