Abstract 12839: Association of Elevated Blood Glucose Level at Admission in Patients With Acute Decompensated Heart Failure and Long-Term Mortality
Introduction: Elevated blood glucose (BG) level has been shown to have adverse short-term prognosis in patients with acute decompensated heart failure (ADHF). Relation of this elevated BG level at hospital admission for ADHF in long term has not been well defined.
Hypothesis: To evaluate the long term prognosis of elevated BG level at the time of admission in ADHF.
Methods: Cohorts of 1684 patients consecutively admitted to the cardiac intensive-care unit from 2007 to 2011 were studied. Among them, 495 patients eligible for the study meeting criteria for ADHF after exclusion of other life threatening conditions such as neoplasms or acute myocardial infarction were divided into 4 groups based on median of BG level (≥131mg/dl or less ) on admission and presence or absence of diabetes mellitus (DM). The risks of each group for all-cause mortality were assessed by multivariable Cox proportional model including other independent variables that showed P<0.1 in univariate analyses.
Results: At a median follow-up of 1.8 years, 148 patients died (29.9%). There were 168 patients without either BG-elevation or DM, 67 without BG-elevation but with DM, 105 with BG-elevation but no DM and 155 with both BG-elevation and DM. In the multivariable model including other independent variables (age, sex, obesity, history of stroke, ischemic heart disease, atrial fibrillation, renal dysfunction, mean blood pressure, B-type natriuretic peptide, hemoglobin, C-reactive protein, sodium and potassium levels, and use of diuretics) compared with patients without either BG-elevation or DM, those with BG-elevation regardless of presence or absence of DM showed a greater risk of increased mortality (Figure).
Conclusions: Elevated BG level at the time of admission in ADHF seems to be a powerful prognostic marker independent of the diabetes status. Targeting therapy for this variable may improve the long-term prognosis in patients with heart failure.
Author Disclosures: S. Kattel: None. T. Kasai: Research Grant; Modest; unrestricted research funding from Philips Respironics, Teijin Home Healthcare, and Fukuda Denshi.. S. Yatsu: None. A. Murata: None. T. Kato: None. S. Suda: None. M. Hiki: None. K. Takasu: None. T. Miyazaki: None. A. Takagi: None. K. Miyauchi: None. H. Daida: None.
- © 2014 by American Heart Association, Inc.