Effect of Glucose Metabolic State Transition on Progression from Stage A to Stage C Heart Failure

Background: Heart failure (HF) constitutes a significant global health challenge. The interplay between the dynamics of glucose metabolic status transitions and the progression of HF has been minimally explored. Objective: We assessed the impact of shifts in glucose metabolic states on the progression from stage A to stage C HF. Methods: The Kailuan Study is a large-scale prospective cohort study. Based on data from the Kailuan Study, 41,110 stage A HF patients were included and stratified into 6 groups based on alterations in glucose metabolic status: stable normoglycemic, stable pre-diabetes, diabetes, normoglycemic progressing to pre-diabetes, pre-diabetes back to normoglycemic, and normoglycemic/pre-diabetes progressing to diabetes. Utilizing the Cox proportional hazards regression model, we calculated the hazard ratios (HR) and 95% confidence intervals (CI) associated with the transition to stage C HF among patients with stage A HF with different glucose metabolic state transitions. Results: Our findings indicated a notably elevated risk for the progression to stage C HF within the diabetic group relative to the stable normoglycemic group (HR, 1.87; 95% CI, 1.66 to 2.10). Additionally, an augmented risk for the progression to stage C HF was observed in the normoglycemic/pre-diabetic to diabetic group (HR, 1.38; 95% CI, 1.15 to 1.65). Conclusion: Both diabetes and normoglycemic/pre-diabetes progressing to diabetes are associated with heightened risks of progressing from stage A to stage C HF. Conversely, the re-establishment of normoglycemic in pre-diabetes is associated with preventing HF progression.