Department of Cardiology, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cardiovasc Diabetol. 2017 Aug 14;16(1):102. doi: 10.1186/s12933-017-0582-y.
High admission blood glucose (ABG) level has been associated with a poor short-term outcome among non-diabetic patients with heart failure (HF). We aimed to investigate the association between ABG levels and long-term (10 years) mortality in patients with or without pre-existing diabetes mellitus (DM) admitted with HF.
We analyzed data on 1811 patients with DM and 2182 patients without pre-existing DM who were hospitalized with HF during a prospective national survey. The relationship between ABG and 10-year mortality was assessed using the Cox proportional hazard model adjusting for multiple variables. ABG was analyzed both as a categorical (<110, 110-140, 140-200, and >200 mg/dL) and as a continuous variable.
At 10 years of follow-up the cumulative probability of mortality was 85 and 78% among patients with DM and patients with no pre-existing DM (p < 0.001), respectively. Among patients with no pre-existing DM, glucose levels of 110-140, 140-200 and ≥200 mg/dL were associated with 9% (p = 0.140), 16% (p = 0.031) and 53% (p < 0.001) increased mortality risk compared to ABG < 110 mg/dL. Each 18-mg/dL (1-mmol/L) increase in glucose level was associated with a 5% increased risk of mortality (p < 0.001) among patients with no-pre-existing DM. In contrast, among patients with DM, only those with glucose levels >200 mg/dL had an increased mortality risk (>200 mg/dL versus <110 mg/dL; HR = 1.20, p = 0.032).
Among hospitalized HF patients with no pre-existing DM there is a linear relationship between ABG level and long-term mortality, whereas among patients with DM only ABG level >200 mg/dL is associated with increased mortality risk.
高入院血糖（ABG）水平与非糖尿病心力衰竭（HF）患者的短期预后不良有关。我们旨在研究 ABG 水平与合并或不合并糖尿病（DM）的 HF 住院患者的长期（10 年）死亡率之间的关系。
我们分析了在一项前瞻性全国性调查中因 HF 住院的 1811 例合并 DM 患者和 2182 例无 DM 的患者的数据。使用 Cox 比例风险模型评估 ABG 与 10 年死亡率之间的关系，并对多个变量进行调整。ABG 既作为分类变量（<110、110-140、140-200 和>200mg/dL），也作为连续变量进行分析。
在 10 年随访期间，合并 DM 的患者和无 DM 的患者的累积死亡率分别为 85%和 78%（p<0.001）。在无 DM 患者中，血糖水平为 110-140、140-200 和≥200mg/dL 与 9%（p=0.140）、16%（p=0.031）和 53%（p<0.001）的死亡率风险增加相关。与 ABG<110mg/dL 相比，血糖水平每升高 18mg/dL（1mmol/L），死亡率风险增加 5%（p<0.001）。相比之下，在合并 DM 的患者中，只有血糖水平>200mg/dL 的患者的死亡率风险增加（>200mg/dL 与<110mg/dL；HR=1.20，p=0.032）。
在无 DM 的 HF 住院患者中，ABG 水平与长期死亡率呈线性关系，而在合并 DM 的患者中，只有 ABG 水平>200mg/dL 与死亡率风险增加相关。
