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In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure

Authors
 Kyeong-Hyeon Chun  ;  Jaewon Oh  ;  Chan Joo Lee  ;  Jin Joo Park  ;  Sang Eun Lee  ;  Min-Seok Kim  ;  Hyun-Jai Cho  ;  Jin-Oh Choi  ;  Hae-Young Lee  ;  Kyung-Kuk Hwang  ;  Kye Hun Kim  ;  Byung-Su Yoo  ;  Dong-Ju Choi  ;  Sang Hong Baek  ;  Eun-Seok Jeon  ;  Jae-Joong Kim  ;  Myeong-Chan Cho  ;  Shung Chull Chae  ;  Byung-Hee Oh  ;  Seok-Min Kang 
Citation
 CARDIOVASCULAR DIABETOLOGY, Vol.21(1) : 291, 2022-12 
Journal Title
CARDIOVASCULAR DIABETOLOGY
Issue Date
2022-12
MeSH
Aged ; Blood Glucose ; Female ; Heart Failure* ; Hospitalization ; Hospitals ; Humans ; Hyperglycemia* ; Male ; Prognosis ; Stroke Volume ; Ventricular Function, Left
Keywords
Glucose metabolism disorder ; Glycemic variability ; Heart failure ; Mortality ; Type 2 diabetes mellitus
Abstract
Background: High glycemic variability (GV) is a poor prognostic marker in cardiovascular diseases. We aimed to investigate the association of GV with all-cause mortality in patients with acute heart failure (HF).

Methods: The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Blood glucose levels were measured at the time of admission, during hospitalization, and at discharge. We included those who had 3 or more blood glucose measurements in this study. Patients were divided into two groups based on the coefficient of variation (CoV) as an indicator of GV. Among survivors of the index hospitalization, we investigated all-cause mortality at 1 year after discharge.

Results: The study analyzed 2,617 patients (median age, 72 years; median left-ventricular ejection fraction, 36%; 53% male). During the median follow-up period of 11 months, 583 patients died. Kaplan-Meier curve analysis revealed that high GV (CoV > 21%) was associated with lower cumulative survival (log-rank P < 0.001). Multivariate Cox proportional analysis showed that high GV was associated with an increased risk of 1-year (HR 1.56, 95% CI 1.26-1.92) mortality. High GV significantly increased the risk of 1-year mortality in non-diabetic patients (HR 1.93, 95% CI 1.47-2.54) but not in diabetic patients (HR 1.19, 95% CI 0.86-1.65, P for interaction = 0.021).

Conclusions: High in-hospital GV before discharge was associated with all-cause mortality within 1 year, especially in non-diabetic patients with acute HF.
Files in This Item:
T202300564.pdf Download
DOI
10.1186/s12933-022-01720-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193015
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