Abstract 11804: The Blood Glucose Concentration at Hospitalization is a Significant Predictor of In-Hospital Death in the Patients With Non-Diabetic Acute Decompensated Heart Failure

Abstract

Background: The blood glucose (BG) concentration (BG≧140 mg/dL) at hospitalization is reported to be the short-term prognostic predictor in patients with acute myocardial infarction. However, it’s significance in patients with acute decompensated heart failure (ADHF) has not been elucidated. Purpose: To evaluate the prognostic power of BG levels at hospitalization in the patients with ADHF. Methods: We analyzed consecutive 517 ADHF patients admitted from January 2007 to December 2013. They were divided into the high BG group (H-BG: BG≧140 mg/dL, n=215) and the low BG group (L-BG: BG<140 mg/dL, n=302) by BG levels in an emergency room. Echocardiographic findings, laboratory data and in-hospital mortality were analyzed. Results: In 517 ADHF patients, the mean age, BG levels at hospitalization, left ventricular ejection fraction (LVEF) and B-type natriuretic peptide (BNP) were 79.7±11.8 years, 153.0±75.2 mg/dL, 52.2±15.8% and 831.5±787.9 pg/mL, respectively. There were no significant differences in age, LVEF and BNP level between H-BG and L-BG groups. The mortality rate in H-BG group was significantly higher than that in L-BG group (17.0% vs 8.1%, p=0.0081). In diabetic ADHF patients (n=138), there was no significant difference in the in-hospital mortality rate between H-BG (n=100) and L-BG (n=38) groups (13.2% vs 24.4%, p=0.1116). However, in non-diabetic ADHF patients (n=379), the in-hospital mortality rate was significantly higher in H-BG (n=115) group compared to L-BG (n=264) group (21.2% vs 5.6%, p<0.0001), and the logistic regression analysis revealed that the BG level at hospitalization could predict the in-hospital death (p=0.0381). The Kaplan-Meier survival curve demonstrated poorer prognosis in H-BG group compared to L-BG group in non-diabetic ADHF patients (Figure, p<0.0001). Conclusion: The BG concentration at hospitalization is a significant predictor of in-hospital death in ADHF patients without diabetes, but not with diabetes.