Giovanni Targher1, Marco Dauriz1, Luigi Tavazzi2, Pier Luigi Temporelli3, Donata Lucci4, Renato Urso5, Gabriella Lecchi6, Giancarlo Bellanti7, Marco Merlo8, Andrea Rossi9, Aldo P Maggioni10. 1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. 2. Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, RA, Italy. 3. Cardiology Division, IRCCS Fondazione Salvatore Maugeri, Veruno, NO, Italy. 4. ANMCO Research Center, Florence, Italy. 5. Department of Medicine, Surgery and Neuroscience, Pharmacology Unit "G. Segre", University of Siena, Siena, Italy. 6. Department of Cardiology, San Leopoldo Mandic Hospital, Merate, LC, Italy. 7. Department of Cardiology, Santa Maria delle Croci Hospital, Ravenna, Italy. 8. Cardiovascular Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, University of Trieste, Trieste, Italy. 9. Division of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. 10. ANMCO Research Center, Florence, Italy. Electronic address: centrostudi@anmco.it.
Abstract
OBJECTIVES: Although diabetes mellitus is frequently associated with heart failure (HF), the association between elevated admission glucose levels and adverse outcomes has not been well established in hospitalized patients with acute HF. METHODS: We prospectively evaluated in-hospital mortality, post-discharge 1-year mortality and 1-year re-hospitalization rates in the Italian Network on Heart Failure (IN-HF) Outcome registry cohort of 1776 patients hospitalized with acute HF and stratified by their admission glucose levels (i.e., known diabetes, newly diagnosed hyperglycemia, no diabetes). RESULTS: Compared with those without diabetes (n = 586), patients with either known diabetes (n = 749) (unadjusted-odds ratio [OR] 1.64, 95%CI 0.99–2.70) or newly diagnosed hyperglycemia (n = 441) (unadjusted-OR 2.34, 95%CI 1.39–3.94) had higher in-hospital mortality, but comparable post-discharge 1-year mortality rates. After adjustment for age, sex, systolic blood pressure, estimated glomerular filtration rate, left ventricular ejection fraction, HF etiology and HF worsening/de novo presentation, the results remained unchanged in patients with known diabetes (adjusted-OR 1.86, 95%CI 1.01–3.42), while achieved borderline significance in those with newly diagnosed hyperglycemia (adjusted-OR 1.81, 95%CI 0.95–3.45). One-year re-hospitalization rates were lower in patients with newly diagnosed hyperglycemia (adjusted-hazard ratio 0.74, 95%CI 0.56–0.96) than in other groups. CONCLUSIONS: Elevated admission blood glucose levels are associated with poorer in-hospital survival outcomes in patients with acute HF, especially in those with previously known diabetes. This finding further highlights the importance of tight glycemic control during hospital stay and address the need of dedicated intervention studies to identify customized clinical protocols to improve in-hospital survival of these high-risk patients.
OBJECTIVES: Although diabetes mellitus is frequently associated with heart failure (HF), the association between elevated admission glucose levels and adverse outcomes has not been well established in hospitalized patients with acute HF. METHODS: We prospectively evaluated in-hospital mortality, post-discharge 1-year mortality and 1-year re-hospitalization rates in the Italian Network on Heart Failure (IN-HF) Outcome registry cohort of 1776 patients hospitalized with acute HF and stratified by their admission glucose levels (i.e., known diabetes, newly diagnosed hyperglycemia, no diabetes). RESULTS: Compared with those without diabetes (n = 586), patients with either known diabetes (n = 749) (unadjusted-odds ratio [OR] 1.64, 95%CI 0.99–2.70) or newly diagnosed hyperglycemia (n = 441) (unadjusted-OR 2.34, 95%CI 1.39–3.94) had higher in-hospital mortality, but comparable post-discharge 1-year mortality rates. After adjustment for age, sex, systolic blood pressure, estimated glomerular filtration rate, left ventricular ejection fraction, HF etiology and HF worsening/de novo presentation, the results remained unchanged in patients with known diabetes (adjusted-OR 1.86, 95%CI 1.01–3.42), while achieved borderline significance in those with newly diagnosed hyperglycemia (adjusted-OR 1.81, 95%CI 0.95–3.45). One-year re-hospitalization rates were lower in patients with newly diagnosed hyperglycemia (adjusted-hazard ratio 0.74, 95%CI 0.56–0.96) than in other groups. CONCLUSIONS: Elevated admission blood glucose levels are associated with poorer in-hospital survival outcomes in patients with acute HF, especially in those with previously known diabetes. This finding further highlights the importance of tight glycemic control during hospital stay and address the need of dedicated intervention studies to identify customized clinical protocols to improve in-hospital survival of these high-risk patients.
Authors: Josep Masip; Marina Povar-Echeverría; William Frank Peacock; Javier Jacob; Víctor Gil; Pablo Herrero; Pere Llorens; Aitor Alquézar-Arbé; Carolina Sánchez; Francisco Javier Martín-Sánchez; Òscar Miró Journal: Intern Emerg Med Date: 2022-03-29 Impact factor: 5.472
Authors: Marco Dauriz; Giovanni Targher; Pier Luigi Temporelli; Donata Lucci; Lucio Gonzini; Gian Luigi Nicolosi; Roberto Marchioli; Gianni Tognoni; Roberto Latini; Franco Cosmi; Luigi Tavazzi; Aldo Pietro Maggioni Journal: J Am Heart Assoc Date: 2017-07-05 Impact factor: 5.501