title: In-hospital and 1-year mortality associated with diabetes in patients with acute heart failure: results from the ESC-HFA Heart Failure Long-Term Registry.
abstract: The aim of this study was to evaluate the in-hospital and 1-year prognostic impact of diabetes and elevated blood glucose levels at hospital admission in patients with acute heart failure (HF).
  
  
  
  We studied a multinational cohort of 6926 hospitalized patients with acute HF enrolled in the European Society of Cardiology (ESC) and Heart Failure Association (HFA) Long-Term Registry, of whom 49.4% (n = 3422) had known or previously undiagnosed diabetes (defined as self-reported history, or medication use, or fasting glucose levels ≥7.0 mmol/L or haemoglobin A1c≥6.5%). Compared with those without diabetes, patients with known or previously undiagnosed diabetes had higher cumulative rates of in-hospital mortality, 1-year mortality, and 1-year HF re-hospitalization that occurred independently of multiple clinical risk factors: in-hospital mortality [6.8 vs. 4.4%; adjusted hazard ratio (HR) 1.774; 95% confidence interval (CI) 1.282-2.456, P < 0.001], 1-year all-cause mortality (27.5 vs. 24%; adjusted HR 1.162; 95% CI 1.020-1.325, P = 0.024), and 1-year hospital re-admissions for HF (23.2 vs. 18.5%; adjusted HR 1.320; 95% CI 1.139-1.530, P < 0.001). Moreover, elevated admission blood glucose concentrations were powerfully prognostic for in-hospital mortality, but not for 1-year mortality or re-hospitalizations, in both patients with and without diabetes.
  
  
  
  Among patients hospitalized for acute HF, the presence of diabetes is independently associated with an increased risk of in-hospital mortality, 1-year all-cause mortality, and 1-year re-hospitalizations for HF, underscoring the need for more effective and personalized treatments of diabetes in this particularly high-risk patient population.
authors: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Giovanni
authors: G
authors: Targher
authors: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors: Marco
authors: M
authors: Dauriz
authors: EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
authors: Cécile
authors: C
authors: Laroche
authors: Cardiology Division, IRCCS Fondazione Salvatore Maugeri, Veruno, NO, Italy.
authors: Pier Luigi
authors: PL
authors: Temporelli
authors: Alexandria University, Alexandria, Egypt.
authors: Mahmoud
authors: M
authors: Hassanein
authors: Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Petar M
authors: PM
authors: Seferovic
authors: Department of Cardiology, Medical University, Lodz, Poland.
authors: Jaroslaw
authors: J
authors: Drozdz
authors: Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research, E.S: Health Science Foundation, Cotignola, Italy.
authors: Roberto
authors: R
authors: Ferrari
authors: Innovative Clinical Trials, Department of Cardiology & Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany.
authors: Stephan
authors: S
authors: Anker
authors: Monash University, Australia and University of Warwick, Coventry, UK.
authors: Andrew
authors: A
authors: Coats
authors: Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain.
authors: Gerasimos
authors: G
authors: Filippatos
authors: Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario, Universitario A Coruna, CHUAC, La Coruna, Spain.
authors: Maria G
authors: MG
authors: Crespo-Leiro
authors: Inserm 942, Hôpital Lariboisière, Université Paris Diderot, Paris, France.
authors: Alexandre
authors: A
authors: Mebazaa
authors: Department of Cardiology, Polichirurgico Hospital G. da Saliceto, Piacenza, Italy.
authors: Massimo F
authors: MF
authors: Piepoli
authors: EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.|ANMCO Research Center, Florence, Italy.
authors: Aldo Pietro
authors: AP
authors: Maggioni
authors: Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, Italy.
authors: Luigi
authors: L
authors: Tavazzi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries
keywords: Acute heart failure; Co-morbidities; Diabetes; Observational outcome study