Ljiljana Jovanovic1, Milena Rajkovic1, Vesna Subota1, Bojana Subotic2, Boris Dzudovic2, Jovan Matijasevic3,4, Marija Benic3, Sonja Salinger5, Stefan Simovic6, Vladimir Miloradovic6, Tamara Preradovic Kovacevic7, Ljiljana Kos7, Aleksandar Neskovic8,9, Srdjan Kafedzic8, Natasa Markovic Nikolic9,10, Bjanka Bozovic11, Nebojsa Bulatovic11,12, Slobodan Obradovic13,14. 1. Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia. 2. Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia. 3. Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. 4. School of Medicine, University of Novi Sad, Novi Sad, Serbia. 5. Clinic of Cardiology, Clinical Center Nis, University of Nis, Nis, Serbia. 6. Clinic of Cardiology, Clinical Center Kragujevac, School of Medicine, University of Kragujevac, Kragujevac, Serbia. 7. Clinic of Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina. 8. Department of Cardiology, Clinical Hospital Center Zemun, Belgrade, Serbia. 9. Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 10. University Clinical Center Zvezdara, School of Medicine, University of Belgrade, Belgrade, Serbia. 11. Clinic of Cardiology, Clinical Center Podgorica, School of Medicine, University of Podgorica, Podgorica, Montenegro. 12. School of Medicine, University of Defense, Belgrade, Serbia. 13. Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia. sloba.d.obradovic@gmail.com. 14. School of Medicine, University of Defense, Belgrade, Serbia. sloba.d.obradovic@gmail.com.
Abstract
AIMS: To examine the relationship between admission glucose (AG) level and short-term in-hospital mortality and to investigate the association between hyperglycemia and major bleeding in PE patients with and without DMT2. METHODS: We evaluated 1165 patients with diagnosed acute PE with multi-detector computed tomography pulmonary angiography (MDCT-PA) enrolled in the Regional multicenter PE registry (REPER). The study population was classified to patients with diabetes mellitus type 2 (DMT2) and those without diabetes. According to quartiles of AG patients, both groups separately were categorized into four subgroups (DMT2 I: < 7.5 mmol/L; II: 7.5-10.0 mmol/L; III: 10.0-15.7 mmol/L; IV: > 15.7 mmol/L and (non-DMT2 I: < 5.5 mmol/L; II: 5.5-6.3 mmol/L; III: 6.3-7.9 mmol/L; IV: > 7.9 mmol/L). RESULTS: All-cause mortality was higher in the DMT2 group (9.5% vs. 18.2%, p < 0.001), and PE-cause mortality was 6% for the patients without DMT2 and 12.4% for DMT2 patients (p = 0.02). The patients in the fourth AG quartiles in both groups, without DMT2 and with DMT2, had significantly higher all-cause and PE-cause in-hospital mortality compared with the first quartile. Rates of major bleeding were similar between the groups. On the multivariable analysis, after adjusting for age, gender and mortality risk, the adherence in the fourth AG quartile had an independent predictive value for all-cause death (HR 2.476, 95% CI 1.017-6.027) only in DM patients. CONCLUSION: In our cohort of patients with acute PE, diabetes was associated with increased rates for all-cause and PE-cause mortality.
AIMS: To examine the relationship between admission glucose (AG) level and short-term in-hospital mortality and to investigate the association between hyperglycemia and major bleeding in PE patients with and without DMT2. METHODS: We evaluated 1165 patients with diagnosed acute PE with multi-detector computed tomography pulmonary angiography (MDCT-PA) enrolled in the Regional multicenter PE registry (REPER). The study population was classified to patients with diabetes mellitus type 2 (DMT2) and those without diabetes. According to quartiles of AG patients, both groups separately were categorized into four subgroups (DMT2 I: < 7.5 mmol/L; II: 7.5-10.0 mmol/L; III: 10.0-15.7 mmol/L; IV: > 15.7 mmol/L and (non-DMT2 I: < 5.5 mmol/L; II: 5.5-6.3 mmol/L; III: 6.3-7.9 mmol/L; IV: > 7.9 mmol/L). RESULTS: All-cause mortality was higher in the DMT2 group (9.5% vs. 18.2%, p < 0.001), and PE-cause mortality was 6% for the patients without DMT2 and 12.4% for DMT2 patients (p = 0.02). The patients in the fourth AG quartiles in both groups, without DMT2 and with DMT2, had significantly higher all-cause and PE-cause in-hospital mortality compared with the first quartile. Rates of major bleeding were similar between the groups. On the multivariable analysis, after adjusting for age, gender and mortality risk, the adherence in the fourth AG quartile had an independent predictive value for all-cause death (HR 2.476, 95% CI 1.017-6.027) only in DM patients. CONCLUSION: In our cohort of patients with acute PE, diabetes was associated with increased rates for all-cause and PE-cause mortality.
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