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Open AccessArticle

Admission Hyperglycemia as a Predictor of Mortality in Acute Heart Failure: Comparison between the Diabetics and Non-Diabetics

1
Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
2
Division of Cardiology, University of Ulsan College of Medicine, Seoul 05505, Korea
3
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea
4
Division of Cardiology, Sungkyunkwan University College of Medicine, Seoul 06351, Korea
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Department of Cardiology, Chungbuk National University College of Medicine, Cheongju 28644, Korea
6
Department of Cardiology, Kyungpook National University College of Medicine, Daegu 41944, Korea
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Department of Cardiovascular Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Department of Cardiology, Yonsei University College of Medicine, Seoul 03722, Korea
9
Division of Cardiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea
10
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
11
National Institute of Health (NIH), Osong 28159, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 149; https://doi.org/10.3390/jcm9010149 (registering DOI)
Received: 23 November 2019 / Revised: 17 December 2019 / Accepted: 31 December 2019 / Published: 6 January 2020
(This article belongs to the Section Cardiology)
Background: To investigate the impact of admission hyperglycemia (HGL) on in-hospital death (IHD) and 1-year mortality in acute heart failure (AHF) patients with or without diabetes mellitus (DM). Methods: Among 5625 AHF patients enrolled in a nationwide registry, 5541 patients were divided into four groups based on the presence of admission HGL and diabetes mellitus (DM). Admission HGL was defined as admission glucose level > 200 mg/dL. IHD and 1-year mortality were compared. Results: IHD developed in 269 patients (4.9%), and 1-year death developed in 1220 patients (22.2%). DM was a significant predictor of 1-year death (24.8% in DM vs. 20.5% in non-DM, p < 0.001), but not for IHD. Interestingly, admission HGL was a significant predictor of both IHD (7.6% vs. 4.2%, p < 0.001) and 1-year death (26.2% vs. 21.3%, p = 0.001). Admission HGL was a significant predictor of IHD in both DM and non-DM group, whereas admission HGL was a significant predictor of 1-year death only in non-DM (27.8% vs. 19.9%, p = 0.003), but not in DM group. In multivariate analysis, admission HGL was an independent predictor of 1-year mortality in non-DM patients (HR 1.32, 95% CI 1.03–1.69, p = 0.030). Conclusion: Admission HGL was a significant predictor of IHD and 1-year death in patients with AHF, whereas DM was only a predictor of 1-year death. Admission HGL was an independent predictor of 1-year mortality in non-DM patients with AHF, but not in DM patients. Careful monitoring and intensive medical therapy should be considered in AHF patients with admission HGL, regardless of DM. View Full-Text
Keywords: acute heart failure; hyperglycemia; diabetes mellitus; mortality acute heart failure; hyperglycemia; diabetes mellitus; mortality
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Cho, J.Y.; Kim, K.H.; Lee, S.E.; Cho, H.-J.; Lee, H.-Y.; Choi, J.-O.; Jeon, E.-S.; Kim, M.-S.; Kim, J.-J.; Hwang, K.-K.; Chae, S.C.; Baek, S.H.; Kang, S.-M.; Choi, D.-J.; Yoo, B.-S.; Ahn, Y.; Park, H.-Y.; Cho, M.-C.; Oh, B.-H. Admission Hyperglycemia as a Predictor of Mortality in Acute Heart Failure: Comparison between the Diabetics and Non-Diabetics. J. Clin. Med. 2020, 9, 149.

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