Abstract 2372: Hemoglobin A1c Levels are Associated with Severity and Prognosis of Systolic Chronic Heart Failure in Non Diabetic Patients
Background: It has been demonstrated that congestive heart failure (CHF) may induce insulin resistance in non diabetic patients. Insulin resistance has been recently associated with clinical outcome in non diabetic CHF patients. However, determination of insulin resistance is not performed in routine clinical practice.
Hypothesis: Since Hemoglobin (Hb) A1c levels reflect ambient glycemic control, we tested the hypothesis that HbA1c levels may be associated with severity and prognosis of CHF in non diabetic patients.
Methods: 602 consecutive patients with systolic CHF (LVEF<45%) were prospectively included. HbA1c levels were determined at entry in the study. Patients with known or unknown diabetes mellitus (fasting glucose >7 mmol/l on 2 determinations during hospitalization) were excluded.
Results: 377 patients were non diabetic (61 years, 77% men). Etiology was ischemic in 48% patients. Mean HbA1c was 5.70.6%. At baseline, high HbA1c levels were associated with more severe CHF (table⇓). During follow up (769±342 days), there were 82 cardiac deaths. High HbA1c levels were associated with higher cardiac mortality (figure⇓). In multivariate analysis, HbA1c levels were independently associated with cardiac mortality (HR=1.4 [1.1–1.9], p=0.02).
Conclusion: Our study shows that HbA1c levels are associated with the severity and the cardiovascular mortality in non diabetic patients.