Admission hyperglycemia predicts mortality in AHF, regardless of diabetes status

  • Cho JY & al.
  • J Clin Med
  • 6 ene. 2020

  • de Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Admission hyperglycemia, not only diabetes status, predicts in-hospital and 1‐year death in patients with acute heart failure (AHF).
  • Consider careful monitoring and intensive heart failure therapy in AHF patients with admission hyperglycemia, regardless of diabetes status.

Why this matters

  • Blood glucose levels can be transiently elevated because of stress response to acute illness.
  • Few data are available on the effect of admission hyperglycemia on clinical outcomes in AHF.

Study design

  • Among AHF patients in nationwide registry, 5541 were divided into 4 groups based on presence/absence of admission hyperglycemia (>200 mg/dL) and diabetes.
  • Funding: Research of Korea Centers for Disease Control and Prevention.

Key results

  • Of 2125 with diabetes (38.6%), diabetes was known in 92.3% and newly diagnosed in 7.7%.
  • Admission hyperglycemia was found in 37.6% with diabetes and 7.3% without.  
  • Admission hyperglycemia significantly predicted death both in hospital (7.6% with vs 4.2% without; P<.001 and at year with vs without>
  • Diabetes predicted death at 1 year (24.8% with vs 20.5% without; P<.001 but not in hospital.>
  • In multivariate analysis, admission hyperglycemia independently predicted in-hospital death (OR, 1.84; P=.017 for diabetes and OR, 2.26; P<.001 nondiabetes and death p=".030)" regardless of diabetes status.>

Limitations

  • Missing registry data.
  • No HbA1c rule-out criteria for suspected diabetes.
  • All-Korean population.