GV effects of diabetes mellitus on clinical outcomes of patients with acute heart failure: A systematic review and meta-analysis
Linna Zhao, Juanjuan Zhang, Weizhe Liu, Cheng Dai, Aiying Li
Abstract
Diabetes mellitus (DM) is identified as a potential modifier of clinical outcomes in acute heart failure (AHF), yet its prognostic impact is not fully determined. This systematic review and meta-analysis aimed to assess the prognostic impact of DM on survival outcomes in AHF patients by synthesizing evidence from 26 studies involving 326,928 subjects collected from Cochrane Library
Introduction
Acute heart failure (AHF) is a sudden clinical syndrome resulting from various factors. The symptoms and signs of heart failure rapidly surface or worsen abruptly, along with increased plasma levels of natriuretic peptides, often posing a life-threatening risk [1–3].
Materials and methods
This meta-analysis followed the Cochrane Handbook for Systematic Reviews of Interventions (for details, see http://training.cochrane.org/handbook) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (File S1) [18]. This study protocol was registered with PROSPERO (CRD: CRD42023420341).
Results
A total of 38,626 articles were retrieved. Of these, 11,170 were excluded due to duplication, 27,211 were dismissed after reviewing titles and abstracts as irrelevant, and 219 were disregarded after reading the full texts (refer to S3 Table). Ultimately, 26 studies were included. Fig 1 illustrates the literature screening process and outcomes.
Discussion
Our findings emphasize the significant impact of DM on all-cause mortality, cardiovascular mortality, and readmission rates, while uncovering a complex relationship with in-hospital mortality and composite endpoints.
Conclusion
This study indicates that exposure to diabetes elevates the risk of adverse outcomes in AHF patients, particularly impacting their survival and hospitalization risk negatively. Consequently, in clinical practice, effective diabetes management and AHF treatment strategies should be developed for these patients to reduce the malignant cycle caused by diabetes and the adverse outcomes of AHF.
Citation: Zhao L, Zhang J, Liu W, Dai C, Li A (2025) GV effects of diabetes mellitus on clinical outcomes of patients with acute heart failure: A systematic review and meta-analysis. PLoS One 20(12): e0338653. https://doi.org/10.1371/journal.pone.0338653
Editor: Oyelola A. Adegboye, Menzies School of Health Research: Charles Darwin University, AUSTRALIA
Received: November 14, 2024; Accepted: November 25, 2025; Published: December 10, 2025
Copyright: © 2025 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: This work was supported by grants from the National Natural Science Foundation of China (82174080) and the Hebei Natural Science Foundation (H2022423333).
Competing interests: The authors have declared that no competing interests exist.
