Glucose variability predicts 6-month mortality in patients hospitalized with acute heart failure

In diabetes mellitus (DM) , glycaemic fluctuations associate with higher oxidative stress than sustained chronic hyperglycaemia and glucose variability increases the risk of chronic diabetic complications. Our hypothesis was that higher glucose variability would associate with mortality after an acu...

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Bibliographic Details
Published in:Internal and emergency medicine 2021-11, Vol.16 (8), p.2121-2128
Main Authors: Cunha, Filipe M., Cidade-Rodrigues, Catarina, Elias, Catarina, Oliveira, Diana, Bettencourt, Paulo, Lourenço, Patrícia
Format: Article
Language:English
Subjects:
Blood glucose
Congestive heart failure
Coronary artery disease
Diabetes
Diabetes mellitus
Glucose
Heart failure
Hyperglycemia
Hypoglycemia
Im - Original
Insulin
Internal Medicine
Ischemia
Medical prognosis
Medicine
Medicine & Public Health
Mortality
Oxidative stress
Ventricle
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Summary:In diabetes mellitus (DM) , glycaemic fluctuations associate with higher oxidative stress than sustained chronic hyperglycaemia and glucose variability increases the risk of chronic diabetic complications. Our hypothesis was that higher glucose variability would associate with mortality after an acute heart failure (HF) episode. We retrospectively analysed patients with DM hospitalized with acute HF between 2009 and 2010. Patients with  30.0%. Follow-up: 6-months. Endpoint: all-cause mortality. A Cox-regression analysis was used to study the association of glucose variability with 6-month mortality. We studied 214 diabetic patients with acute HF, 49.1% male, mean age 76 years. Mean glycaemia during hospitalization was 187 ± 50 mg/dL, hypoglycaemia ( 30.0% had higher mean glycaemia, more hypoglycaemic episodes and higher HbA1c; they were also more often treated with insulin. Patients were similar concerning age, gender, comorbidities, left ventricular systolic dysfunction and ischemic heart disease. During the 6-month follow-up, 38 (17.8%) patients died. Patients with GCV > 30.0% had a HR of 6-month mortality of 2.21 (95% CI: 1.16–4.21), p  = 0.02. This association with more than twofold higher short-term mortality was independent of main confounders. Elevated glycaemic variability in acute HF admissions of patients with DM predicts short-term mortality. Patients with GCV > 30.0% have an independent more than twofold higher risk of 6-month death after an acute HF hospitalization.
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-021-02719-7