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Journal of Clinical Medicine, 2020.9, 149-0, DOI: https://doi.org/10.3390/jcm9010149
Admission Hyperglycemia as a Predictor of Mortality in Acute Heart Failure: Comparison between the Diabetics and Non-Diabetics
Jae Yeong Cho, Kye Hun Kim; Sang Eun Lee; Hyun-Jai Cho; Hae-Young Lee; Jin-Oh Choi; Eun-Seok Jeon; Min-Seok Kim; Jae-Joong Kim; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Dong-Ju Choi; Byung-Su Yoo; Youngkeun Ahn; Hyun-Young Park; Myeong-Chan Cho; Byung-Hee Oh
Background: To investigate the impact of admission hyperglycemia (HGL) on in-hospital death (IHD) and 1-year mortality in acute heart failure (AHF) patients with or without diabetes mellitus (DM).
Methods: Among 5625 AHF patients enrolled in a nationwide registry, 5541 patients were divided into four groups based on the presence of admission HGL and diabetes mellitus (DM). Admission HGL was defined as admission glucose level > 200 mg/dL. IHD and 1-year mortality were compared.
Results: IHD developed in 269 patients (4.9%), and 1-year death developed in 1220 patients (22.2%). DM was a significant predictor of 1-year death (24.8% in DM vs. 20.5% in non-DM, p < 0.001), but not for IHD. Interestingly, admission HGL was a significant predictor of both IHD (7.6% vs. 4.2%, p < 0.001) and 1-year death (26.2% vs. 21.3%, p = 0.001). Admission HGL was a significant predictor of IHD in both DM and non-DM group, whereas admission HGL was a significant predictor of 1-year death only in non-DM (27.8% vs. 19.9%, p = 0.003), but not in DM group. In multivariate analysis, admission HGL was an independent predictor of 1-year mortality in non-DM patients (HR 1.32, 95% CI 1.03-1.69, p = 0.030).
Conclusion: Admission HGL was a significant predictor of IHD and 1-year death in patients with AHF, whereas DM was only a predictor of 1-year death. Admission HGL was an independent predictor of 1-year mortality in non-DM patients with AHF, but not in DM patients. Careful monitoring and intensive medical therapy should be considered in AHF patients with admission HGL, regardless of DM.
- DOI: https://doi.org/10.3390/jcm9010149
- ISBN or ISSN: 2077-0383
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.