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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

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http://hdl.handle.net/2183/22184
Atribución-NoComercial-SinDerivadas 3.0 España
Except where otherwise noted, this item's license is described as Atribución-NoComercial-SinDerivadas 3.0 España
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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
Author(s)
Targher, Giovanni
Dauriz, Marco
Laroche, Cecile
Temporelli, Pier Luigi
Hassanein, Mahmoud
Seferovic, Petar M.
Drozdz, Jaroslaw
Ferrari, Roberto
Anker, Stefan
Coats, Andrew
Filippatos, Gerasimos
Crespo-Leiro, María Generosa
Mebazaa, Alexandre
Piepoli, Massimo F.
Maggioni, Aldo P.
Tavazzi, Luigi
Date
2016-10-28
Citation
Targher G, Dauriz M, Laroche C, et al. 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. Eur J Heart Fail. 2017; 19(1): 54-65
Abstract
[Abstract] AIMS: 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). METHODS AND RESULTS: 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. CONCLUSIONS: 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.
Keywords
Co-morbidities
Diabetes
Acute heart failure
Observational outcome study
 
Editor version
https://doi.org/10.1002/ejhf.679
Rights
Atribución-NoComercial-SinDerivadas 3.0 España
 
This is the peer reviewed version of the article which has been published in final form at Wiley Online Library. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for self-archiving.
 
ISSN
1879-0844

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