Carrera Santaliestra, M. JoséMoliner Borja, PedroLlauradó Cabot, GemmaEnjuanes Grau, CristinaConangla, LauraChillarón Jordan, Juan JoséBallesta, SilviaCliment Biescas, ElisendaComín Colet, JosepFlores-Le-Roux, Juana Antonia2022-10-032022-10-032021Carrera 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/jcm110100062077-0383http://hdl.handle.net/10230/54235Acute 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.application/pdfeng© 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/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/jcm11010006Chronic complicationsDiabetes mellitusHeart failureinfo:eu-repo/semantics/openAccess