Prognostic value of the acute-to-chronic glycemic ratio at admission in heart failure: a prospective study

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  • dc.contributor.author Carrera Santaliestra, M. José
  • dc.contributor.author Moliner Borja, Pedro
  • dc.contributor.author Llauradó Cabot, Gemma
  • dc.contributor.author Enjuanes Grau, Cristina
  • dc.contributor.author Conangla, Laura
  • dc.contributor.author Chillarón Jordan, Juan José
  • dc.contributor.author Ballesta, Silvia
  • dc.contributor.author Climent Biescas, Elisenda
  • dc.contributor.author Comín Colet, Josep
  • dc.contributor.author Flores-Le-Roux, Juana Antonia
  • dc.date.accessioned 2022-10-03T05:39:18Z
  • dc.date.available 2022-10-03T05:39:18Z
  • dc.date.issued 2021
  • dc.description.abstract Acute hyperglycemia has been associated with worse prognosis in patients hospitalized for heart failure (HF). Nevertheless, studies evaluating the impact of glycemic control on long-term prognosis have shown conflicting results. Our aim was to assess the relationship between acute-to-chronic (A/C) glycemic ratio and 4-year mortality in a cohort of subjects hospitalized for acute HF. A total of 1062 subjects were consecutively included. We measured glycaemia at admission and estimated average chronic glucose levels and the A/C glycemic ratio were calculated. Subjects were stratified into groups according to the A/C glycemic ratio tertiles. The primary endpoint was 4-year mortality. Subjects with diabetes had higher risk for mortality compared to those without (HR 1.35 [95% CI: 1.10-1.65]; p = 0.004). A U-shape curve association was found between glucose at admission and mortality, with a HR of 1.60 [95% CI: 1.22-2.11]; p = 0.001, and a HR of 1.29 [95% CI: 0.97-1.70]; p = 0.078 for the first and the third tertile, respectively, in subjects with diabetes. Additionally, the A/C glycemic ratio was negatively associated with mortality (HR 0.76 [95% CI: 0.58-0.99]; p = 0.046 and HR 0.68 [95% CI: 0.52-0.89]; p = 0.005 for the second and third tertile, respectively). In multivariable analysis, the A/C glycemic ratio remained an independent predictor. In conclusion, in subjects hospitalized for acute HF, the A/C glycemic ratio is significantly associated with mortality, improving the ability to predict mortality compared with glucose levels at admission or average chronic glucose concentrations, especially in subjects with diabetes.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Carrera MJ, Moliner P, Llauradó G, Enjuanes C, Conangla L, Chillarón JJ, Ballesta S, Climent E, Comín-Colet J, Flores-Le Roux JA. Prognostic value of the acute-to-chronic glycemic ratio at admission in heart failure: a prospective study. J Clin Med. 2021 Dec 21;11(1):6. DOI: 10.3390/jcm11010006
  • dc.identifier.doi http://dx.doi.org/10.3390/jcm11010006
  • dc.identifier.issn 2077-0383
  • dc.identifier.uri http://hdl.handle.net/10230/54235
  • dc.language.iso eng
  • dc.publisher MDPI
  • dc.relation.ispartof J Clin Med. 2021 Dec 21;11(1):6
  • dc.rights © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri https://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Chronic complications
  • dc.subject.keyword Diabetes mellitus
  • dc.subject.keyword Heart failure
  • dc.title Prognostic value of the acute-to-chronic glycemic ratio at admission in heart failure: a prospective study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion