Admission Blood Glucose Levels And Prognosis In Nondiabetic Patients With Acute Heart Failure

Objective: To assess the association between admission glucose levels and outcome in nondiabetic patients with acute heart failure. Methods: Data on 145 nondiabetic patients with acute heart failure or exacerbation of chronic heart failure admitted to the department of Cardiology, the 2nd Affiliated Hospital, Medical College of Zhejiang University, from Jan 2005 to Dec 2006 was collected. The indices, including age, gender, etiology, clinical symptoms, signs, echo test and regimen, were recorded. Results: 1) A total of 145 patients with acute heart failure or exacerbation of chronic heart failure were enrolled. The majority (62%) were males and the average age was 66 years. Of them, half were diagnosed with NYHAIV. The length of stay (LOS) is 14 days. Common causes of heart failure were hypertension (34%), coronary heart disease (32%), dilated cardiomyopathy (31%) and vavular heart disease (17%). The propotion in use of ACEI/ARB, β-blocker, diuretics and digoxin was 79%,53%,55% and 28%. 2) In-hospital mortality was about10 times as high as in patients with admission glucose levels in the third tertile (22%), compared with the first (2%) and the second (2%) tertile (P<0.01). Admission glucose levels are associated with in-hospital mortality and the Spearman coefficient is 0.382 (P<0.01), of which the odds ratio (OR) is 1.071. 3) Besides admission glucose levels, C-reactive protein, c-Troponin I, serum sodium and blood urea nitrogen are all in correlation with in-hospital mortality and Spearman coefficient are 0.327, 0.316, -0.291 and 0.288 respectively (P<0.01). Conclusions: Elevated admission glucose levels are associated with increased in-hospital mortality and admission glucose levels can be used to predict outcome of nondiabetic patients with acute heart failure. Risk stratification, due to glucose levels, can conduce to evaluation of disease severity and promotion of treatment.