Clinical Report: Independent Risk Factors for Heart Failure in T2DM Patients

Overview

This study identifies seven independent risk factors for in-hospital heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) and acute ST-segment elevation myocardial infarction (STEMI) post-percutaneous coronary intervention (PCI). A nomogram prediction model was developed, demonstrating strong predictive capability and calibration.

Background

Heart failure is a significant complication following myocardial infarction, particularly in patients with T2DM, who are at increased risk due to underlying pathophysiological factors. Identifying risk factors for HF in this population can enhance clinical decision-making and improve patient outcomes. This study aims to provide a predictive tool to identify high-risk patients early in their hospital course.

Data Highlights

Key Findings

• Seven independent risk factors for in-hospital HF were identified: prior myocardial infarction, smoking history, diminished left ventricular ejection fraction, heightened white blood cell count, reduced hemoglobin level, increased platelet count, and atrial fibrillation.
• The nomogram model showed an area under the curve (AUC) of 0.845, indicating strong predictive capability.
• Calibration of the nomogram was confirmed with a Hosmer-Lemeshow goodness-of-fit test (P=0.712).
• Sensitivity analysis demonstrated the model's stability with no significant multicollinearity (all VIF <1.5).
• External validation of the nomogram is necessary before clinical application.

Clinical Implications

Healthcare professionals should consider these identified risk factors when assessing patients with T2DM and STEMI for potential heart failure. The nomogram can serve as a preliminary tool for early identification of high-risk patients, guiding clinical interventions and monitoring strategies.

Conclusion

The study provides valuable insights into the risk factors for heart failure in T2DM patients post-PCI, along with a promising predictive model. Further external validation is essential to establish its clinical utility.

Related Resources & Content

1. Clinical Research in Cardiology, 2025 -- Effects of Diabetes on Clinical Outcomes in Patients with ST-Elevation Myocardial Infarction and Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention
2. Clinical Research in Cardiology, 2023 -- Physiology-Guided Percutaneous Coronary Intervention in Diabetic Patients with Intermediate Coronary Artery Disease
3. Drugs - Real World Outcomes, 2021 -- Association of Sodium-Glucose Cotransporter-2 Inhibitors with Decreased Heart Failure Hospitalization Risk in Patients with Preserved Ejection Fraction and Type 2 Diabetes Mellitus
4. Clinical Research in Cardiology, 2019 -- Effectiveness of Implantable Cardioverter-Defibrillators in Diabetic Patients with Heart Failure and Reduced Ejection Fraction
5. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes, American Heart Association
6. Systematic review and meta-analysis of risk prediction models for heart failure after PCI in patients with acute myocardial infarction, BMC Cardiovascular Disorders
7. Study to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction, American College of Cardiology
8. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes - Professional Heart Daily | American Heart Association
9. Systematic review and meta - analysis of risk prediction models for heart failure after PCI in patients with acute myocardial infarction | BMC Cardiovascular Disorders | Springer Nature Link
10. Study to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction - American College of Cardiology