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Blood glucose predicted death in acute HF
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New data demonstrate a significant association between blood glucose concentrations and 30-day all-cause mortality in patients presenting with acute HF.
In a multinational study, researchers found a higher median blood glucose concentration among patients with acute HF who died when compared with those who survived 30 days after presentation (8.9 mmol/L vs. 7.4 mmol/L; P<.0001). A fully adjusted model also indicated that an elevated blood glucose level was an independent predictor of 30-day mortality in acute HF (OR=2.19; 95% CI, 1.69-2.83). Elevated blood glucose concentrations remained associated with increased risk for mortality across all subgroups of patients, the researchers said, including those with preserved (HR=5.41; 95% CI, 2.44-12) and impaired (HR=2.37; 95% CI, 1.57-3.59) systolic function. Analyses also showed that the addition of blood glucose level to clinical parameters resulted in a net reclassification improvement of 4.4% (95% CI, 0.99-7.78).
The study population was composed of 6,212 patients (mean age, 72 years; 52.5% men) with acute HF from 12 different cohorts throughout Europe, Asia, Africa and the United States. Forty-one percent had a past diagnosis of diabetes, and median blood glucose concentration on presentation to the hospital was 7.5 mmol/L. Ten percent of patients died after 30 days.
“In this large multinational cohort of patients with [acute HF], we showed that an elevated blood glucose level is common and is a powerful risk marker, predicting death within 30 days. Our results are consistent with basic and clinical science data linking an elevated blood glucose level with myocardial injury, impaired myocardial performance, arrhythmia, and risk of ventricular remodeling. Further studies are needed to understand more thoroughly the pathophysiology of hyperglycemia in [acute HF],” the researchers wrote.
“Because blood glucose is easily modifiable, it may represent a valid target for therapeutic intervention,” they wrote.
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.
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