Admission blood glucose and 10-year mortality among patients with or without pre-existing diabetes mellitus hospitalized with heart failure

• Main Authors: Osnat Itzhaki Ben Zadok, Ran Kornowski, Ilan Goldenberg, Robert Klempfner, Yoel Toledano, Yitschak Biton, Enrique Z. Fisman, Alexander Tenenbaum, Gregory Golovchiner, Ehud Kadmon, Alexander Omelchenko, Tuvia Ben Gal, Alon Barsheshet
• Format: Article
• Language: English
• Published: BMC 2017-08-01
• Series: Cardiovascular Diabetology
• Subjects: Heart failure; Diabetes mellitus; Prognosis; Admission blood glucose
• Online Access: http://link.springer.com/article/10.1186/s12933-017-0582-y

Abstract Background High admission blood glucose (ABG) level has been associated with a poor short-term outcome among non-diabetic patients with heart failure (HF). We aimed to investigate the association between ABG levels and long-term (10 years) mortality in patients with or without pre-existing diabetes mellitus (DM) admitted with HF. Methods We analyzed data on 1811 patients with DM and 2182 patients without pre-existing DM who were hospitalized with HF during a prospective national survey. The relationship between ABG and 10-year mortality was assessed using the Cox proportional hazard model adjusting for multiple variables. ABG was analyzed both as a categorical (<110, 110–140, 140–200, and >200 mg/dL) and as a continuous variable. Results At 10 years of follow-up the cumulative probability of mortality was 85 and 78% among patients with DM and patients with no pre-existing DM (p < 0.001), respectively. Among patients with no pre-existing DM, glucose levels of 110–140, 140–200 and ≥200 mg/dL were associated with 9% (p = 0.140), 16% (p = 0.031) and 53% (p < 0.001) increased mortality risk compared to ABG < 110 mg/dL. Each 18-mg/dL (1-mmol/L) increase in glucose level was associated with a 5% increased risk of mortality (p < 0.001) among patients with no-pre-existing DM. In contrast, among patients with DM, only those with glucose levels >200 mg/dL had an increased mortality risk (>200 mg/dL versus <110 mg/dL; HR = 1.20, p = 0.032). Conclusion Among hospitalized HF patients with no pre-existing DM there is a linear relationship between ABG level and long-term mortality, whereas among patients with DM only ABG level >200 mg/dL is associated with increased mortality risk.