Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Subjects
2.2. Study Protocol
2.3. Outcome Measures
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Mortality during the Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All (n = 1062) | Patients without Diabetes (n = 278) | Patients with Pre-Diabetes (n = 194) | Patients with Diabetes (n = 590) | p for Trend | |
---|---|---|---|---|---|
Male sex (n, %) | 602 (56.7) | 153 (55.0) | 112 (57.7) | 337 (57.1) | 0.803 |
Age (years) | 72.6 ± 11.2 | 71.2 ± 12.6 | 72.6 ± 13.2 | 73.2 ± 9.7 ¤ | 0.046 |
Current smokers (n, %) | 157 (14.8) | 39 (14.0) | 34 (17.5) | 84 (14.2) | 0.786 |
BMI (kg/m2) | 28.4 ± 5.9 | 27.2 ± 5.3 | 28 ± 6.5 | 29.1 ± 5.8 ¤ ¥ | <0.001 |
Waist (cm) | 103.4 ± 14.2 | 98.9 ± 14.4 | 101.7 ± 13.8 | 105.9 ± 14.2 ¤ ¥ | <0.001 |
Hypertension (n, %) | 862 (81.2) | 191 (68.7) | 153 (78.9) | 518 (87.8) * ¤ ¥ | <0.001 |
Systolic blood pressure (mmHg) | 123.5 ± 22.0 | 120.1 ± 21.6 | 120.0 ± 22.2 | 126.1 ± 21.7 ¤ ¥ | <0.001 |
Diastolic blood pressure (mmHg) | 67.2 ± 12.9 | 67.3 ± 13.2 | 66.6 ± 12.6 | 67.3 ± 12.8 | 0.768 |
Dyslipidemia (n, %) | 593 (55.8) | 109 (39.2) | 81 (41.8) | 403 (68.3) ¤ ¥ | <0.001 |
Statin use (n, %) | 633 (59.6) | 124 (44.6) | 101 (52.1) | 408 (69.2) * ¤ ¥ | <0.001 |
Total cholesterol (mmol/L) | 3.92 ± 0.99 | 4.14 ± 1.04 | 4.08 ± 0.97 | 3.77 ± 1.03 ¤ ¥ | <0.001 |
LDL-C (mmol/L) | 2.22 ± 0.80 | 2.43 ± 0.81 | 1.55 ± 0.78 | 2.08 ± 0.78 ¤ ¥ | <0.001 |
HDL-C (mmol/L) | 1.10 ± 0.32 | 1.13 ± 0.33 | 1.17 ± 0.28 | 1.07 ± 0.33 ¥ | <0.001 |
Triglycerides (mmol/L) | 1.40 ± 0.66 | 1.40 ± 0.74 | 1.30 ± 0.54 | 1.44 ± 0.66 ¥ | 0.049 |
COPD (n, %) | 237 (22.3) | 51 (18.3) | 44 (22.7) | 142 (24.1) | 0.152 |
Previous stroke (n, %) | 119 (11.2) | 28 (10.1) | 18 (9.2) | 73 (12.4) | 0.379 |
Peripheral vasculopathy (n, %) | 176 (16.6) | 33 (11.9) | 21 (10.8) | 122 (20.7) ¤ ¥ | <0.001 |
Laboratory values | |||||
Creatinine (mmol/L) | 0.12 ± 0.06 | 0.12 ± 0.05 | 0.011 ± 0.05 | 0.12 ± 0.07 ¥ | 0.004 |
eGFR MDRD < 60 (mL/min/1.73m2) | 277 (26.1) | 61 (21.9) | 35 (18.0) | 18 (3.1) ¤ ¥ | <0.001 |
Hemoglobin (g/L) | 12.6 ± 2.8 | 12.7 ± 1.9 | 12.9 ± 2.1 | 13.4 ± 3.3 | 0.047 |
Albumin (g/dL) | 3.78 ± 0.48 | 3.78 ± 0.45 | 3.90 ± 0.51 | 3.76 ± 0.48 * ¥ | 0.001 |
NT-proBNP (pg/mL) | 1626 (700–4051) | 1412 (639–3425) | 1537 (652–3246) | 1775 (719–4456) | 0.103 |
LVEF ≤40% (n, %) | 485 (45.7) | 144 (51.8) | 81 (41.8) | 260 (44.1) | 0.057 |
NYHA class (n, %) | 0.011¤ | ||||
-Class l | 146 (13.7) | 38 (13.7) | 45 (23.2) | 65 (11.0) | |
-Class II | 440 (41.4) | 128 (46.0) | 70 (36.1) | 240 (40.8) | |
-Class III | 388 (36.5) | 94 (33.8) | 58 (29.9) | 236 (40.0) | |
-Class IV | 88 (8.3) | 18 (6.5) | 21 (10.8) | 49 (8.3) | |
HF etiology (n, %) | <0.001 | ||||
-Ischemic | 428 (40.3) | 83 (29.9) | 60 (30.9) | 285 (48.3) ¤ ¥ | |
-Hypertensive | 372 (35.0) | 94 (33.8) | 72 (37.1) | 206 (34.9) | |
-Others | 262 (24.7) | 101 (36.3) | 62 (32.0) | 189 (32.0) | |
Atrial fibrillation (n, %) | 354 (33.3) | 100 (36.0) | 74 (38.1) | 180 (30.5) | 0.083 |
Implantable cardioverter defibrillator (n, %) | 15 (1.4) | 8 (2.9) | 0 (0) | 7 (1.2) | 0.011 |
Last-year acute heart failure admission (n, %) | 858 (80.8) | 212 (76.3) | 149 (76.8) | 497 (84.2) | 0.005 |
Cardiovascular medication | |||||
-ACE inhibitors (n, %) | 632 (59.5) | 182 (65.5) | 110 (56.7) | 340 (57.6)¤ | 0.029 |
-ARBs (n, %) | 172 (16.2) | 44 (15.8) | 39 (20.1) | 89 (15.1) | 0.308 |
-β-Blockers (n, %) | 927 (87.3) | 251 (90.3) | 161 (83.0) | 515 (87.3) * ¤ | 0.047 |
-Nitrates (n, %) | 327 (30.8) | 54 (19.4) | 41 (21.1) | 233 (39.5) ¤ ¥ | <0.001 |
-Aldosterone antagonists (n, %) | 397 (37.4) | 115 (41.4) | 71 (36.6) | 211 (35.8) | 0.287 |
-Diuretics (n, %) | 958 (90.2) | 247 (88.8) | 173 (89.2) | 538 (91.2) | 0.433 |
-Antiagregant (n, %) | 494 (46.5) | 92 (33.1) | 73 (37.6) | 329 (55.8) ¤ ¥ | <0.001 |
-Amiodarone (n, %) | 102 (9.6) | 33 (11.9) | 18 (9.3) | 51 (8.6) ¤ ¥ | 0.334 |
Variables | HR (95% CI) | p Value |
---|---|---|
Age (years) | 1.04 (1.03–1.05) | <0.001 |
Sex (female vs. male) | 1.04 (0.88–1.23) | 0.637 |
Smoking (yes vs. no) | 0.97 (0.89–1.05) | 0.421 |
BMI (kg/m2) | 0.97 (0.96–0.99) | <0.001 |
Hypertension (yes vs. no) | 1.36 (1.08–1.71) | <0.010 |
Dyslipidemia (yes vs. no) | 1.01 (0.85–1.20) | 0.884 |
Statin use (yes vs. no) | 1.06 (0.89–1.26) | 0.532 |
CKD (yes vs. no) | 1.68 (1.41–2.02) | <0.001 |
Hemoglobin (g/dL) | 0.93 (0.89–0.97) | <0.001 |
Albumin (g/dL) | 0.56 (0.47–0.68) | <0.001 |
Troponin T | 1.14 (1.06–1.24) | 0.001 |
NT-proBNP (pg/mL) | 2.31 (1.98–2.70) | <0.001 |
LVEF ≤ 40% (yes vs. no) | 0.93 (0.79–1.11) | 0.431 |
NYHA class (III–IV vs. I–II) | 1.79 (1.50–2.13) | <0.001 |
HF of ischemic etiology (yes vs. no) | 1.49 (1.26–1.77) | <0.001 |
Previous stroke (yes vs. no) | 1.29 (0.99–1.65) | 0.050 |
Previous peripheral artery disease (yes vs. no) | 1.42 (1.15–1.75) | 0.001 |
Previous COPD (yes vs. no) | 1.34 (1.11–1.63) | 0.003 |
Last-year acute heart failure admission (yes vs. no) | 1.88 (1.46–2.42) | <0.001 |
Variables | HR (95% CI) | p Value |
---|---|---|
Age (years) | 1.03 (1.02–1.04) | <0.001 |
HF of ischemic etiology (yes vs. no) | 1.38 (1.12–1.71) | 0.003 |
NT-proBNP (pg/mL) | 2.05 (1.68–2.51) | <0.001 |
A/C glycemic ratio (third tertile) | 0.79 (0.64–0.99) | 0.040 |
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Carrera, M.J.; Moliner, P.; Llauradó, G.; Enjuanes, C.; Conangla, L.; Chillarón, J.-J.; Ballesta, S.; Climent, E.; Comín-Colet, J.; Flores-Le Roux, J.-A. Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study. J. Clin. Med. 2022, 11, 6. https://doi.org/10.3390/jcm11010006
Carrera MJ, Moliner P, Llauradó G, Enjuanes C, Conangla L, Chillarón J-J, Ballesta S, Climent E, Comín-Colet J, Flores-Le Roux J-A. Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study. Journal of Clinical Medicine. 2022; 11(1):6. https://doi.org/10.3390/jcm11010006
Chicago/Turabian StyleCarrera, Mª José, Pedro Moliner, Gemma Llauradó, Cristina Enjuanes, Laura Conangla, Juan-José Chillarón, Silvia Ballesta, Elisenda Climent, Josep Comín-Colet, and Juana-Antonia Flores-Le Roux. 2022. "Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study" Journal of Clinical Medicine 11, no. 1: 6. https://doi.org/10.3390/jcm11010006
APA StyleCarrera, M. J., Moliner, P., Llauradó, G., Enjuanes, C., Conangla, L., Chillarón, J.-J., Ballesta, S., Climent, E., Comín-Colet, J., & Flores-Le Roux, J.-A. (2022). Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study. Journal of Clinical Medicine, 11(1), 6. https://doi.org/10.3390/jcm11010006