Serum glucose level at hospital admission correlates with left ventricular systolic dysfunction in nondiabetic, acute coronary patients: the Hellenic Heart Failure Study.

The purpose of this work was to evaluate the relation between serum glucose levels at hospital admission and left ventricular systolic function in nondiabetic patients with an acute coronary syndrome (ACS). Of the 1000 ACS patients who were consecutively enrolled during 2007-2008, 583 (63 +/- 13 years, 20% females) nondiabetic patients were studied in this work. Of these, 254 presented left ventricular systolic dysfunction (ejection fraction <40%). Biochemical measurements and detailed medical information were recorded in all participants. Patients having glucose levels at hospital admission in the highest tertile (>155 mg/dl) had lower left ventricular ejection fraction (40% vs 45%, P = 0.003), were older (66 +/- 11 vs 61 +/- 13, P = 0.004) and less physically active (49% vs 63%, P = 0.02), had higher troponin (14.7 +/- 39.7 vs 5.6 +/- 13.5, P = 0.03), higher brain natriuretic peptide (510.39 +/- 932.33 vs 213.4 +/- 301.14, P = 0.008), higher C-RP (42.26 +/- 55.26 vs 26.46 +/- 38.18, P = 0.04), lower creatinine clearance levels (68 +/- 33 vs.81 +/- 31, P = 0.009), higher white blood cell count (13 416 +/- 16 420 vs 9310 +/- 3020, P = 0.001), and lower body mass index (26.8 +/- 4 vs 27.2 +/- 4.4, P = 0.07), compared to those in the lowest tertile (<114 mg/dl). The multiadjusted logistic regression analysis revealed that a 10 mg/dl difference in glucose levels was independently associated with 8% (95% confidence interval 2%-14%) higher likelihood of left ventricular systolic dysfunction. Low glucose concentrations at hospital admission in nondiabetic post-ACS patients is a predictor for the appearance of left ventricular dysfunction, and could be a target marker for risk stratification.