[Prognostic importance of abnormal glucose metabolism in chronic heart failure].
OBJECTIVE
To investigate the importance of abnormal glucose metabolism in a chronic heart failure (CHF) population.


METHODS
A total of 444 patients were enrolled sequentially for decompensated CHF from January 1st, 2005 to December 31st, 2007 at our department. They were divided into diabetic (n = 153, 34.5%) and non-diabetic groups (n = 291, 65.5%). Among the non-diabetics, there were 113 (25.4%) with impaired fasting glucose (IFG) (FPG 5.6-6.9 mmol/L) and 178 (40.1%) with normal glucose levels. All subjects received a follow-up to record their clinical status, biochemical parameters and end-point events (all-cause death in one year). And the correlations of abnormal glucose metabolism and end-point events were analyzed.


RESULTS
Among these patients, 83 (17.1%) died in 1 year, 31 (7.0%) were lost to follow-up; Among 83 dead patients, 15 (8.4%) were within normal glucose levels, 34 (21.2%) with IFG and 44 (28.8%) with diabetes mellitus. Compared with normal glucose level patients, the mortality rates of diabetes mellitus and IFG patients were higher (P < 0.01). There was no significant difference in mortality rate between diabetes mellitus and IFG patients. After adjustment for other prognostic attributes (age, sex and etc.), diabetes mellitus was a predictor of 1-year all-cause mortality (OR = 2.383, 95% CI: 1.317 to 4.312; P = 0.004). In diabetics, the mortality of the higher glucose level group (FPG > 7.0 mmol/L) was 30.4% and that of the lower glucose level group (FPG < or = 7.0 mmol/L) 27.4%. And there was no significant difference (P > 0.05). The FPG level could not predict the 1-year all-cause mortality. In non-diabetics, the mortality of IFG group (FPG 5.6 - 6.9 mmol/L) was significantly higher than that of normal glucose levels group (21.2% vs 8.4%, P < 0.01). IFG status predicted 1-year all-cause mortality (OR = 3.564, 95%CI: 1.494 - 8.497, P = 0.004). The FPG level was also associated with the 1-year all-cause mortality (OR = 1.791, 95%CI: 1.090 - 2.943, P = 0.021).


CONCLUSIONS
Diabetes mellitus is an independent predictor of 1-year all-cause mortality for CHF. And IFG and a higher FPG level are associated with 1-year all-cause mortality for CHF without diabetes mellitus.
Guo
Jing-chuan
JC
Department of Cardiology, Peking University Third Hospital, Key Laboratory of Ministry of Education on Molecular Cardiology, Beijing 100191, China.
Li
Zhao-ping
ZP
Gao
Wei
W
Guo
Yan-hong
YH
Mao
Jie-min
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D044882:Glucose Metabolism Disorders / Q000378:metabolism; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
D001786:Blood Glucose