Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure
Gerbaud, Edouard
CHU Bordeaux
de la Poterie, Ambroise Bouchard
CHU Bordeaux
Baudinet, Thomas
CHU Bordeaux
Montaudon, Michel
Institut National de la Sante et de la Recherche Medicale (Inserm)
Beauvieux, Marie-Christine
CHU Bordeaux
Lemaitre, Anne-Iris
CHU Bordeaux
Cetran, Laura
CHU Bordeaux
Seguy, Benjamin
CHU Bordeaux
Picard, Francois
CHU Bordeaux
Velayoudom, Fritz-Line
CHU Guadeloupe
Ouattara, Alexandre
Bordeaux Univ
Kabore, Remi
Institut National de la Sante et de la Recherche Medicale (Inserm)
Coste, Pierre
CHU Bordeaux
Domingues-Dos-Santos, Pierre
Institut National de la Sante et de la Recherche Medicale (Inserm)
Catargi, Bogdan
CHU Bordeaux
Journal
Journal of Clinical Medicine
ISSN
2077-0383
Open Access
gold
Volume
11
(1) Background: Hyperglycaemia and hypoglycaemia are both emerging risk factors for cardiovascular disease. Nevertheless, the potential effect of glycaemic variability (GV) on mid-term major cardiovascular events (MACE) in diabetic patients presenting with acute heart failure (AHF) remains unclear. This study investigates the prognostic value of GV in diabetic patients presenting with acute heart failure (AHF). (2) Methods: this was an observational study including consecutive patients with diabetes and AHF between January 2015 and November 2016. GV was calculated using standard deviation of glycaemia values during initial hospitalisation in the intensive cardiac care unit. MACE, including recurrent AHF, new-onset myocardial infarction, ischaemic stroke and cardiac death, were recorded. The predictive effects of GV on patient outcomes were analysed with respect to baseline characteristics and cardiac status. (3) Results: In total, 392 patients with diabetes and AHF were enrolled. During follow-up (median (interquartile range) 29 (6-51) months), MACE occurred in 227 patients (57.9%). In total, 92 patients died of cardiac causes (23.5%), 107 were hospitalised for heart failure (27.3%), 19 had new-onset myocardial infarction (4.8%) and 9 (2.3%) had an ischaemic stroke. Multivariable logistic regression analysis showed that GV > 50 mg/dL (2.70 mmol/L), age > 75 years, reduced left ventricular ejection fraction (LVEF < 30%) and female gender were independent predictors of MACE: hazard ratios (HR) of 3.16 (2.25-4.43; p < 0.001), 1.54 (1.14-2.08; p = 0.005), 1.47 (1.06-2.07; p = 0.02) and 1.43 (1.05-1.94; p = 0.03), respectively. (4) Conclusions: among other well-known factors of HF, a GV cut-off value of >50 mg/dL was the strongest independent predictive factor for mid-term MACE in patients with diabetes and AHF.