In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure
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...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01720-4 |
| _version_ | 1797973812707328000 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Kyeong-Hyeon Chun |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T04:10:12Z |
| format | Article |
| id | doaj.art-edd0ab38cb0446c79e00b8c03f25e66b |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-11T04:10:12Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-edd0ab38cb0446c79e00b8c03f25e66b2023-01-01T12:12:26ZengBMCCardiovascular Diabetology1475-28402022-12-0121111210.1186/s12933-022-01720-4In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failureKyeong-Hyeon Chun0Jaewon Oh1Chan Joo Lee2Jin Joo Park3Sang Eun Lee4Min-Seok Kim5Hyun-Jai Cho6Jin-Oh Choi7Hae-Young Lee8Kyung-Kuk Hwang9Kye Hun Kim10Byung-Su Yoo11Dong-Ju Choi12Sang Hong Baek13Eun-Seok Jeon14Jae-Joong Kim15Myeong-Chan Cho16Shung Chull Chae17Byung-Hee Oh18Seok-Min Kang19Division of Cardiology, National Health Insurance Service Ilsan HospitalCardiology Division, Department of Internal Medicine, Severance Hospital, Cardiovascular Research Institute, Yonsei University College of MedicineCardiology Division, Department of Internal Medicine, Severance Hospital, Cardiovascular Research Institute, Yonsei University College of MedicineDivision of Cardiology, Seoul National University Bundang HospitalDivision of Cardiology, Asan Medical CenterDivision of Cardiology, Asan Medical CenterDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Sungkyunkwan University College of MedicineDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Chungbuk National University College of MedicineDepartment of Internal Medicine, Chonnam National UniversityDepartment of Internal Medicine, Yonsei University Wonju College of MedicineDivision of Cardiology, Seoul National University Bundang HospitalDepartment of Internal Medicine, The Catholic University of KoreaDepartment of Internal Medicine, Sungkyunkwan University College of MedicineDivision of Cardiology, Asan Medical CenterDepartment of Internal Medicine, Chungbuk National University College of MedicineDepartment of Internal Medicine, Kyungpook National University College of MedicineDepartment of Internal Medicine, Mediplex Sejong HospitalCardiology Division, Department of Internal Medicine, Severance Hospital, Cardiovascular Research Institute, Yonsei University College of MedicineAbstract 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.https://doi.org/10.1186/s12933-022-01720-4Glucose metabolism disorderGlycemic variabilityType 2 diabetes mellitusHeart failureMortality |
| spellingShingle | 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 In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure Cardiovascular Diabetology Glucose metabolism disorder Glycemic variability Type 2 diabetes mellitus Heart failure Mortality |
| title | In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure |
| title_full | In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure |
| title_fullStr | In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure |
| title_full_unstemmed | In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure |
| title_short | In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure |
| title_sort | in hospital glycemic variability and all cause mortality among patients hospitalized for acute heart failure |
| topic | Glucose metabolism disorder Glycemic variability Type 2 diabetes mellitus Heart failure Mortality |
| url | https://doi.org/10.1186/s12933-022-01720-4 |
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