Premium
In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the ESC‐HFA Heart Failure Long‐Term Registry
Author(s) -
Targher Giovanni,
Dauriz Marco,
Laroche Cécile,
Temporelli Pier Luigi,
Hassanein Mahmoud,
Seferovic Petar M.,
Drozdz Jaroslaw,
Ferrari Roberto,
Anker Stephan,
Coats Andrew,
Filippatos Gerasimos,
CrespoLeiro Maria G.,
Mebazaa Alexandre,
Piepoli Massimo F.,
Maggioni Aldo Pietro,
Tavazzi Luigi
Publication year - 2017
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.679
Subject(s) - medicine , heart failure , hazard ratio , diabetes mellitus , confidence interval , mortality rate , cohort , endocrinology
Aims The aim of this study was to evaluate the in‐hospital and 1‐year prognostic impact of diabetes and elevated blood glucose levels at hospital admission in patients with acute heart failure ( HF ). Methods and results We studied a multinational cohort of 6926 hospitalized patients with acute HF enrolled in the European Society of Cardiology ( ESC ) and Heart Failure Association ( HFA ) Long‐Term Registry, of whom 49.4% ( n = 3422) had known or previously undiagnosed diabetes (defined as self‐reported history, or medication use, or fasting glucose levels ≥7.0 mmol/L or haemoglobin A 1c ≥6.5%). Compared with those without diabetes, patients with known or previously undiagnosed diabetes had higher cumulative rates of in‐hospital mortality, 1‐year mortality, and 1‐year HF re‐hospitalization that occurred independently of multiple clinical risk factors: in‐hospital mortality [6.8 vs. 4.4%; adjusted hazard ratio ( HR ) 1.774; 95% confidence interval ( CI ) 1.282–2.456, P < 0.001], 1‐year all‐cause mortality (27.5 vs. 24%; adjusted HR 1.162; 95% CI 1.020–1.325, P = 0.024), and 1‐year hospital re‐admissions for HF (23.2 vs. 18.5%; adjusted HR 1.320; 95% CI 1.139–1.530, P < 0.001). Moreover, elevated admission blood glucose concentrations were powerfully prognostic for in‐hospital mortality, but not for 1‐year mortality or re‐hospitalizations, in both patients with and without diabetes. Conclusions Among patients hospitalized for acute HF , the presence of diabetes is independently associated with an increased risk of in‐hospital mortality, 1‐year all‐cause mortality, and 1‐year re‐hospitalizations for HF , underscoring the need for more effective and personalized treatments of diabetes in this particularly high‐risk patient population.