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 and James L. Jr. JANUZZI. Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure Results From an International Observational Cohort. Journal of The American College of Cardiology. New York: Elsevier Science Inc., 2013, vol. 61, No 8, p. 820-829. ISSN 0735-1097. doi:10.1016/j.jacc.2012.11.054.
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Basic information
Original name Association Between Elevated Blood Glucose and Outcome in Acute Heart Failure Results From an International Observational Cohort
Authors MEBAZAA, Alexandre (250 France), Jindřich ŠPINAR (203 Czech Republic, guarantor, belonging to the institution), Etienne GAYAT (250 France), Johan LASSUS (246 Finland), Taly MEAS (250 France), Christian MUELLER (756 Switzerland), Aldo MAGGIONI (380 Italy), Frank PEACOCK (840 United States of America), Harjola VELI-PEKKA (246 Finland), Roland van KIMMENADE (528 Netherlands), Atul PATHAK (250 France), Thomas MUELLER (40 Austria), Luigi TAVAZZI (380 Italy), Salvatore di SOMMA (380 Italy), Marco METRA (380 Italy), Domingo PASCUAL-FIGAL (724 Spain), Said LARIBI (250 France), Damien LOGEART (250 France), Semir NOUIRA (788 Tunisia), Naoki SATO (392 Japan), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), Nicolas DEYE (250 France), Riadh BOUKEF (250 France), Corinne COLLET (250 France), Greet Van den BERGHE (56 Belgium), Alain COHEN-SOLAL (250 France) and James L. Jr. JANUZZI (840 United States of America).
Edition Journal of The American College of Cardiology, New York, Elsevier Science Inc. 2013, 0735-1097.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 15.343
RIV identification code RIV/00216224:14110/13:00068284
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.jacc.2012.11.054
UT WoS 000315199400005
Keywords in English acute heart failure; blood glucose; 30-day mortality; hyperglycemia
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 11. 10. 2013 14:41.
Abstract
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
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