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@article{1106871,
author = {Mebazaa, Alexandre and Špinar, Jindřich and Gayat, Etienne and Lassus, Johan and Meas, Taly and Mueller, Christian and Maggioni, Aldo and Peacock, Frank and VeliandPekka, Harjola and Kimmenade, Roland van and Pathak, Atul and Mueller, Thomas and Tavazzi, Luigi and Somma, Salvatore di and Metra, Marco and PascualandFigal, Domingo and Laribi, Said and Logeart, Damien and Nouira, Semir and Sato, Naoki and Pařenica, Jiří and Deye, Nicolas and Boukef, Riadh and Collet, Corinne and Berghe, Greet Van den and CohenandSolal, Alain and Januzzi, James L. Jr.},
article_location = {New York},
article_number = {8},
doi = {http://dx.doi.org/10.1016/j.jacc.2012.11.054},
keywords = {acute heart failure; blood glucose; 30-day mortality; hyperglycemia},
language = {eng},
issn = {0735-1097},
journal = {Journal of The American College of Cardiology},
title = {Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure Results From an International Observational Cohort},
volume = {61},
year = {2013}
}
TY - JOUR
ID - 1106871
AU - Mebazaa, Alexandre - Špinar, Jindřich - Gayat, Etienne - Lassus, Johan - Meas, Taly - Mueller, Christian - Maggioni, Aldo - Peacock, Frank - Veli-Pekka, Harjola - Kimmenade, Roland van - Pathak, Atul - Mueller, Thomas - Tavazzi, Luigi - Somma, Salvatore di - Metra, Marco - Pascual-Figal, Domingo - Laribi, Said - Logeart, Damien - Nouira, Semir - Sato, Naoki - Pařenica, Jiří - Deye, Nicolas - Boukef, Riadh - Collet, Corinne - Berghe, Greet Van den - Cohen-Solal, Alain - Januzzi, James L. Jr.
PY - 2013
TI - Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure Results From an International Observational Cohort
JF - Journal of The American College of Cardiology
VL - 61
IS - 8
SP - 820-829
EP - 820-829
PB - Elsevier Science Inc.
SN - 07351097
KW - acute heart failure
KW - blood glucose
KW - 30-day mortality
KW - hyperglycemia
N2 - Objective The aim of this analysis was to assess the association between elevated blood glucose level and mortality in acute heart failure (AHF). Background Elevated blood glucose has been reported to be prognostically meaningful in patients with cardiac diagnoses, such as coronary artery disease. The short-term prognostic impact of hyperglycemia in AHF is unknown, however. Methods In a multinational cohort of AHF, we examined the ability of blood glucose concentrations at presentation to predict all-cause mortality by 30 days. Fully adjusted models for prognosis included a previous diagnosis of diabetes mellitus as a covariate. Results A total of 6,212 subjects with AHF (mean age, 72 years; 52.5% male) were studied; the median blood glucose concentration on arrival at the hospital was 7.5 mmol/l (135 mg/dl), and 41% had a previous diagnosis of diabetes mellitus (DM). After 30 days, 618 patients (10%) had died. Compared with survivors, decedents had significantly higher median blood glucose concentrations (8.9 mmol/l vs. 7.4 mmol/l; p < 0.0001). In the fully adjusted model, an elevated blood glucose level was an independent predictor of 30-day mortality in AHF (odds ratio: 2.19; 95% confidence interval: 1.69 to 2.83; p < 0.001). The risk associated with an elevated blood glucose level appeared consistent across all subgroups of patients, including patients with preserved (hazard ratio: 5.41; 95% confidence interval: 2.44 to 12.0; p < 0.0001) and impaired systolic function (hazard ratio: 2.37; 95% confidence interval: 1.57 to 3.59; p < 0.0001). Furthermore, in reclassification analyses, elevated blood glucose added significant prognostic information to clinical parameters alone (4.4% net reclassification improvement; p = 0.01). Conclusions Among patients with AHF, blood glucose concentrations at presentation are powerfully prognostic for 30-day mortality, independent of a diagnosis of diabetes mellitus or other clinical variables. Because blood glucose is easily modifiable, it may represent a valid target for therapeutic intervention. (J Am Coll Cardiol 2013;61:820-9) (C) 2013 by the American College of Cardiology Foundation
ER -
MEBAZAA, Alexandre, Jindřich ŠPINAR, Etienne GAYAT, Johan LASSUS, Taly MEAS, Christian MUELLER, Aldo MAGGIONI, Frank PEACOCK, Harjola VELI-PEKKA, Roland van KIMMENADE, Atul PATHAK, Thomas MUELLER, Luigi TAVAZZI, Salvatore di SOMMA, Marco METRA, Domingo PASCUAL-FIGAL, Said LARIBI, Damien LOGEART, Semir NOUIRA, Naoki SATO, Jiří PAŘENICA, Nicolas DEYE, Riadh BOUKEF, Corinne COLLET, Greet Van den BERGHE, Alain COHEN-SOLAL a James L. Jr. JANUZZI. Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure Results From an International Observational Cohort. \textit{Journal of The American College of Cardiology}. New York: Elsevier Science Inc., 2013, roč.~61, č.~8, s.~820-829. ISSN~0735-1097. doi:10.1016/j.jacc.2012.11.054.
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