Impact of diabetes mellitus on mortality and atrial fibrillation in hypertrophic cardiomyopathy: A systematic review and meta-analysis

doi:10.4239/wjd.v16.i12.110494

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 16, Issue 12

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (17)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-3) series, Tables (1-2) series.

Item

Count

PDF

HTML

Figures (1-3)

Tables (1-2)

Sum=34

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=3

Dec 15, 2025 (publication date) through Dec 15, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Diabetes

ISSN

1948-9358

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

World J Diabetes. Dec 15, 2025; 16(12): 110494
Published online Dec 15, 2025. doi: 10.4239/wjd.v16.i12.110494

Impact of diabetes mellitus on mortality and atrial fibrillation in hypertrophic cardiomyopathy: A systematic review and meta-analysis

Nanush Damarlapally, Roopeessh Vempati, Kesha Mayank Doshi, Manavjot Singh, Kesar Prajapati, Dhruvi Modi, Pooja Singh, Rupak Desai

Nanush Damarlapally, Department of Health Sciences, Houston Community College-Coleman Campus, Houston, TX 77030, United States

Roopeessh Vempati, Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI 48341, United States

Kesha Mayank Doshi, Department of Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad 380016, India

Manavjot Singh, Department of Medicine, Dayanand Medical College, Ludhiana 141001, Punjab, India

Kesar Prajapati, Department of Internal Medicine, Metropolitan Hospital Center, New York City Health and Hospitals Corporation, New York, NY 10029, United States

Dhruvi Modi, Department of Internal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj 370001, Gujarat, India

Pooja Singh, Department of Internal Medicine, Multicare Tacoma General Hospital, Tacoma, WA 98405, United States

Rupak Desai, Independent Researcher, Atlanta, GA 30079, United States

Co-first authors: Nanush Damarlapally and Roopeessh Vempati.

Author contributions: Damarlapally N and Vempati R contributed equally to this work as co-first authors, conceptualized and designed the study, developed the methodology, performed data curation and formal analysis, drafted the original manuscript, and supervised the project; Doshi KM and Singh M contributed to methodology, performed data extraction, assisted with statistical interpretation, and participated in reviewing and editing the manuscript; Prajapati K and Modi D contributed to data collection and curation and participated in manuscript drafting and critical revision; Singh P assisted with data organization and manuscript review and editing; Desai R provided senior oversight, validated the analysis, contributed to the editing of the manuscript, and supervised the overall project administration. All authors have read and approved the final manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Rupak Desai, MBBS, Independent Researcher, Scottdale, Atlanta, GA 30079, United States. drrupakdesai@gmail.com

Received: June 9, 2025
Revised: July 28, 2025
Accepted: November 3, 2025
Published online: December 15, 2025
Processing time: 190 Days and 15.2 Hours

Abstract

BACKGROUND

Diabetes mellitus (DM) is a significant risk factor for cardiovascular diseases and can worsen the risk of cardiovascular events among patients with hypertrophic cardiomyopathy (HCM). However, strong evidence is needed to show the impact of DM on all-cause mortality (ACM) and atrial fibrillation (AF), which we explored in this systematic review and meta-analysis.

AIM

To determine the impact of DM on ACM and AF in patients with HCM.

METHODS

PubMed, Google Scholar, and EMBASE databases were searched for studies showing the effect of DM on ACM and AF in HCM. A binary random effects model with a 95% confidence interval (CI) was used to pool odds ratios (ORs) for ACM and AF outcomes. Study quality was assessed using the Joanna Briggs Institute’s critical appraisal tool and leave-one-out sensitivity analysis. P < 0.05 was considered statistically significant.

RESULTS

Fourteen studies (n = 106138) with a mean age of 61.76 ± 19.84 years and 61.55% males were included in our systematic review; ten studies (n = 102882) were eligible for meta-analysis. In the unadjusted analysis, DM was not significantly associated with ACM (OR = 0.96; 95%CI: 0.43-2.15; P = 0.93). However, after adjustment, DM showed a significant association with higher ACM risk (adjusted OR = 1.37; 95%CI: 1.16-1.61; P < 0.01). DM was significantly associated with AF in both unadjusted (OR = 2.02; 95%CI: 1.14-3.58; P = 0.04) and adjusted analyses (adjusted OR = 2.68; 95%CI: 1.68-4.27; P = 0.01). The Joanna Briggs Institute tool revealed a low risk of bias. Leave-one-out sensitivity analysis, performed by sequentially excluding each study, demonstrated no significant change in the overall effect estimates, indicating the robustness and stability of our results.

CONCLUSION

DM significantly increased the risk of ACM and AF, highlighting the importance of tighter glycemic control and cardiovascular risk factor modification among patients with HCM.

Keywords: All-cause mortality; Atrial fibrillation; Arrhythmia; Cardiovascular disease; Diabetes mellitus; Heart failure; Hypertrophic cardiomyopathy; Hypertrophic obstructive cardiomyopathy

Core Tip: This meta-analysis evaluated the impact of diabetes mellitus (DM) on clinical outcomes in patients with hypertrophic cardiomyopathy (HCM), focusing on all-cause mortality and atrial fibrillation. The findings underscore the importance of recognizing DM as a modifier of adverse outcomes in HCM, particularly due to its contribution to arrhythmias and cardiac dysfunction. The included studies had a low risk of bias, and sensitivity analyses confirmed the robustness of the results. Clinicians should consider more aggressive glycemic and cardiovascular risk factor control in HCM patients with comorbid diabetes to reduce preventable complications and improve long-term outcomes. This study fills a crucial gap in evidence linking DM to poor prognosis in HCM.