Assessment of 5-year Heart Failure Risk in Type 2 Diabetic Patients Using the WATCH-DM Risk Score in an Ambulatory Diabetic Clinic, Nakhonping Hospital

Abstract

Objectives: To assess and stratify the 5-year risk of developing heart failure (HF) among patients with type 2 diabetes mellitus (T2DM) receiving treatment at the outpatient diabetes clinic of Nakornping Hospital, utilizing the WATCH-DM risk score. Methods: This retrospective analytical study retrieved data from the electronic medical record of Nakornping Hospital between 2019 and 2024. The initial cohort consisted of 13,958 patients. After screening to exclude cases with missing data for any of the 10 WATCH-DM variables and removing biologically implausible data, a final sample of 2,382 patients (17.1%) with complete data was retained. Statistical analyses comparing the different risk groups were performed using the Kruskal-Wallis test for continuous variables and the Chi-squared test for categorical variables. Results: The final sample of 2,382 patients had a mean age of 64.3±11.7 years, a mean WATCH-DM score of 7.6±2.9, and a mean eGFR of 72.6± 27.4 mL/min/1.73m². The subjects were grouped into 5 risk categories as follows: very low risk, 1,214 patients (51.0%); low risk, 574 patients (24.1%); moderate risk, 206 patients (8.6%); high risk, 330 patients (13.9%); and very high risk, 58 patients (2.4%). A combined total of 388 patients (16.3%) in the high and very high-risk groups required proactive care from pharmacists. There were statistically significant differences among the various risk groups (P < 0.001) across the variables of age, systolic blood pressure, eGFR, HDL-C levels, and history of myocardial infarction. Conclusions: The WATCH-DM risk score can be utilized to stratify the risk of HF in patients with T2DM within the context of Thai outpatient clinics. Approximately 1 in 6 patients (16.3%) fell into the groups requiring proactive clinical pharmacy interventions from pharmacists. These findings support the crucial role of clinical pharmacists in preventing cardiovascular complications in patients with diabetes.