Admission blood glucose level and mortality among hospitalized nondiabetic patients with heart failure.
BACKGROUND
The significance of admission blood glucose level in nondiabetic patients with heart failure (HF) is unknown. We examined the possible association between admission glucose levels and outcome in a large cohort of hospitalized patients with HF.


METHODS
We analyzed the data of 4102 patients with HF, who were hospitalized during a prospective national survey. The present study focuses on a subgroup of 1122 nondiabetic patients with acute HF who were admitted because of acute HF or exacerbation of chronic HF.


RESULTS
In-hospital mortality was twice as high in patients with admission blood glucose levels in the third tertile (7.2%) compared with the first (3%) and second (4%) tertiles (P = .02). Furthermore, mortality risk was correlated with admission glucose levels; each 18-mg/dL (1-mmol/L) increase in glucose level was associated with a 31% increased risk of in-hospital mortality (adjusted odds ratio, 1.31; 95% confidence interval, 1.10-1.57; P = .003) and a 12% increase in 60-day mortality (adjusted hazard ratio, 1.12; 95% confidence interval, 1.01-1.25; P = .04). Admission blood glucose levels remained an independent predictor of in-hospital and 60-day mortality even after the exclusion of 315 patients (28%) with acute myocardial infarction and HF. The 6- and 12-month mortality rates were similar in patients with and without abnormal admission blood glucose levels.


CONCLUSIONS
Elevated admission blood glucose levels are associated with increased in-hospital and 60-day mortality, but not 6-month or 1-year mortality, in nondiabetic patients hospitalized because of HF.
Barsheshet
Alon
A
Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer 52621, Israel.
Garty
Moshe
M
Grossman
Ehud
E
Sandach
Amir
A
Lewis
Basil S
BS
Gottlieb
Shmuel
S
Shotan
Abraham
A
Behar
Solomon
S
Caspi
Avi
A
Schwartz
Roseline
R
Tenenbaum
Alexander
A
Leor
Jonathan
J
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies
D015415:Biomarkers; D001786:Blood Glucose