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Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study

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) g...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745704/
https://www.ncbi.nlm.nih.gov/pubmed/35011747
http://dx.doi.org/10.3390/jcm11010006
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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
author_facet 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
author_sort Carrera, Mª José
collection PubMed
description 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.
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spelling pubmed-87457042022-01-11 Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study 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 J Clin Med Article 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. MDPI 2021-12-21 /pmc/articles/PMC8745704/ /pubmed/35011747 http://dx.doi.org/10.3390/jcm11010006 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title_full Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title_fullStr Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title_full_unstemmed Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title_short Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Heart Failure: A Prospective Study
title_sort prognostic value of the acute-to-chronic glycemic ratio at admission in heart failure: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745704/
https://www.ncbi.nlm.nih.gov/pubmed/35011747
http://dx.doi.org/10.3390/jcm11010006
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