Key result
Elevated blood glucose levels on admission in patients with acute decompensated heart failure were associated with a significantly increased risk of long-term mortality (HR 1.79), regardless of diabetes status.
Why the study?
Does elevated blood glucose level on admission increase long-term mortality in patients with acute decompensated heart failure?
Cohort (n=495)
No
Does elevated blood glucose level on admission increase long-term mortality in patients with acute decompensated heart failure?
Hazard Ratio: 1.79
Absolute Event Rate: 32.4% vs 28%
p-value: p=0.042
Elevated blood glucose on admission is a prognostic marker for increased long-term mortality in patients with acute decompensated heart failure, regardless of their underlying diabetes status.
Supports admission hyperglycemia as a prognostic marker in acute decompensated heart failure; leaves open whether targeted control improves survival.
BACKGROUND: The effect of elevated blood glucose (BG) levels on the long-term prognosis of acute decompensated heart failure (ADHF) patients has not been well defined. The purpose of this study is to evaluate the long-term prognosis of ADHF with elevated BG. METHODS: A cohort of patients consecutively admitted to the cardiac intensive care unit from 2007 to 2011 was studied. Among these, 495 patients who met the criteria were divided into 4 groups based on their BG level and diabetes mellitus (DM) status. The risks for all-cause mortality in each group were assessed using the multivariate Cox proportional hazards model. RESULTS: At a median follow-up of 1.8 years, 148 patients had died. There were 168 patients without either BG elevation or DM, 67 without BG elevation but with DM, 105 with BG elevation but not DM, and 155 with both BG elevation and DM. In a multivariate model, those with BG elevation, regardless of DM status, showed a greater risk of increased mortality when compared with patients without either BG elevation or DM [hazard ratio (HR), 1.79; p=0.042 for BG elevation without DM and HR, 1.73; p=0.048 for BG elevation with DM]. CONCLUSION: Elevated BG levels, irrespective of the DM status, at the time of admission in patients with ADHF, appear to be a prognostic marker for ADHF.
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Kattel et al. (2016) conducted a cohort in Acute decompensated heart failure (n=495). Elevated blood glucose level on admission (≥131 mg/dl) vs. No blood glucose elevation and no diabetes mellitus was evaluated on All-cause mortality (HR 1.79, p=0.042). Elevated blood glucose levels on admission in patients with acute decompensated heart failure were associated with a significantly increased risk of long-term mortality (HR 1.79), regardless of diabetes status.
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