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Title: | Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study |
Author: | Carrera, Mª José Moliner, Pedro Llauradó, Gemma Enjuanes, Cristina Conangla, Laura Chillarón, Juan José Ballesta, Silvia Climent, Elisenda Comín Colet, Josep Flores le Roux, Juana Antonia |
Keywords: | Insuficiència cardíaca Diabetis Heart failure Diabetes |
Issue Date: | 21-Dec-2021 |
Publisher: | MDPI AG |
Abstract: | Acute hyperglycemia has been associated with worse prognosis in patients hospitalized for heart failure (HF). Nevertheless, studies evaluating the impact of glycemic control on long-term prognosis have shown conflicting results. Our aim was to assess the relationship between acute-to-chronic (A/C) glycemic ratio and 4-year mortality in a cohort of subjects hospitalized for acute HF. A total of 1062 subjects were consecutively included. We measured glycaemia at admission and estimated average chronic glucose levels and the A/C glycemic ratio were calculated. Subjects were stratified into groups according to the A/C glycemic ratio tertiles. The primary endpoint was 4-year mortality. Subjects with diabetes had higher risk for mortality compared to those without (HR 1.35 [95% CI: 1.10-1.65]; p = 0.004). A U-shape curve association was found between glucose at admission and mortality, with a HR of 1.60 [95% CI: 1.22-2.11]; p = 0.001, and a HR of 1.29 [95% CI: 0.97-1.70]; p = 0.078 for the first and the third tertile, respectively, in subjects with diabetes. Additionally, the A/C glycemic ratio was negatively associated with mortality (HR 0.76 [95% CI: 0.58-0.99]; p = 0.046 and HR 0.68 [95% CI: 0.52-0.89]; p = 0.005 for the second and third tertile, respectively). In multivariable analysis, the A/C glycemic ratio remained an independent predictor. In conclusion, in subjects hospitalized for acute HF, the A/C glycemic ratio is significantly associated with mortality, improving the ability to predict mortality compared with glucose levels at admission or average chronic glucose concentrations, especially in subjects with diabetes. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/jcm11010006 |
It is part of: | Journal of Clinical Medicine, 2021, vol 11, num 1 |
URI: | http://hdl.handle.net/2445/183105 |
Related resource: | https://doi.org/10.3390/jcm11010006 |
ISSN: | 2077-0383 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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jcm-11-00006-v3.pdf | 9.39 MB | Adobe PDF | View/Open |
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