Stress Hyperglycemia ratio and In-hospital Adverse clinical outcome in Patients of Decompensated Chronic Heart Failure and Type II Diabetes Mellitus

• Background: Diabetes Mellitus (DM) is usually associated with patients admitted with decompensated chronic heart failure. Stress hyperglycemia ratio (SHR) reflects uncontrolled levels of blood glucose and stress induced hyperglycemia. Higher SHR levels are an indicator to increase the risk of adverse outcomes in patients with chronic heart failure, especially those with diabetes mellitus.• Aim of study: detect the ability of SHR to predict adverse outcomes in type II diabetic patients hospitalized for decompensated chronic heart failure (DCHF) during hospitalization guided with Get with the Guidelines–Heart Failure (GWTG-HF).• Patients and methods: All hospitalized patients with decompensated chronic heart failure (DCHF) and type II DM were included in this study. DCHF is defined as high BNP or NT-pro BNP values and severe LV diastolic dysfunction or LV systolic impairment or structural abnormalities previously diagnosed by echocardiography then presentation with rapid deterioration in signs and symptoms of heart failure resulting in unplanned emergency room visit and hospitalization. SHR is derived by dividing admission mean blood glucose levels (MGL) by HBA1c-derived estimated average glucose (eAG) which is detected by this equation [eAG = 28.7 × HbA1C – 46.7]. • Results: SHR above the cut-off value (1.62) had sensitivity 81.2 % and specificity 71.5% (AUC=0.745, P value< 0.00) to predict adverse clinical outcomes in hospitalized diabetic patients with DCHF correlated with (GWTG-HF) score calculated for these patients at time of hospital admission.• Conclusion: SHR had a significant role to predict in-hospital adverse clinical outcomes in diabetic patients hospitalized with DCHF.