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Colegio de Medicina Interna de México.

2022, Número 5

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Med Int Mex 2022; 38 (5)


Diabetes mellitus tipo 2 en una clínica de insuficiencia cardiaca de un centro de referencia latinoamericano

Palmezano-Díaz JM, Saldarriaga-Giraldo CI, Torres-Yepes V, Tobón-Upegui PM

Idioma: Español
Referencias bibliográficas: 37
Paginas: 990-1000
Archivo PDF: 226.34 Kb.


RESUMEN

Objetivo: Describir las características y el pronóstico de los pacientes con insuficiencia cardiaca y diabetes.
Materiales y Métodos: Estudio de cohorte única retrospectiva en una población de pacientes con diabetes e insuficiencia cardiaca del centro de referencia de Colombia, realizado de 2012 a 2020.
Resultados: Se analizaron 1477 pacientes, 299 (20.2%) eran diabéticos, 95 (6.4%) eran prediabéticos y 1083 (73.3%) no eran diabéticos. De los pacientes con diabetes, se analizaron 287, la mediana de edad fue de 70.2 años, 191 (66.6%) eran hombres, 167 (58.2%) tenían cardiopatía isquémica, 264 (92%) hipertensión arterial, 204 (71.1%) dislipidemia, 178 (62%) sobrepeso, 143 (49.8%) enfermedad renal crónica. En relación con la terapia médica de insuficiencia cardiaca, recibían IECA/ARA II 207 (72%), ARNI 28 (9.8%), betabloqueadores 269 (93.7%), antialdosterona 183 (63.8%), diuréticos 214 (74.6%). Para el tratamiento de la diabetes recibían insulina 148 (51.6%), biguanidas 165 (57.4%), SGLT2 37 (12.9%), IDDP4 47 (16.4%), GLP1 15 (5.2%), sulfonilureas 7 (2.4%). Con respecto a los dispositivos cardiacos, 53 (18.5%) tenían TCR, 48 (16.7%) tenían un CDI, 24 (8.4%) tenían un marcapasos. De los pacientes con revascularización coronaria en 93 (32.4%) fue percutánea y en 51 (17.8%) fue quirúrgica. La mortalidad fue de 33 (11.5%) pacientes en el programa de insuficiencia cardiaca institucional.
Conclusiones: En este grupo de pacientes con insuficiencia cardiaca con diabetes, encontramos una alta carga de comorbilidades, baja prescripción de SGLT2 y manejo farmacológico contra insuficiencia cardiaca óptimo.


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