Patients with Acute Heart Failure Syndromes (AHFS) are not only common in the emergency department, they are also associated with high short-term and long-term mortality rates. AHFS patients may encounter hyperglycemia, which occurs in up to 40% of patients regardless of whether they have a history of diabetes.

This blog post is based on a study published by the European Heart Journal. The study was compromised of 16,524 patients (18 years or older) with AHFS in the Emergency Department located in Ontario, Canada. The risk analysis was for 30-day mortality, new diabetes diagnosis and hospitalization outcomes.

The Details

The median age of heart failure patients who were either hospitalized or discharged from the emergency department was 79. The total number of men was 8115, and 9275 patients did not have pre-existing diabetes. The median blood glucose was 8.9 mmol/L (160 mg/dL) in patients with diabetes and 6.4 mmol/L (115 mg/dL) in patients without diabetes.

The Results

Patients with diabetes with a blood glucose exceeding 11.1 mmol/L (200 mg/dL) compared with a blood glucose of 3.9-6.1 mmol/L (70-110 mg/dL) significantly increased the risk of mortality. Patients without pre-existing diabetes with a blood glucose exceeding 6.1 mmol/L (110 mg/dL) had a significantly higher all-cause mortality risk as well as cardiovascular mortality risk. The study revealed that patients with higher blood glucose levels, regardless of having diabetes.

The Relevance

Patients who have high blood glucose levels are susceptible to future diabetes, hospitalizations for diabetes, heart failure, and early death.  With tight glycemic control and a controlled blood glucose range, the rates associated with these risks can be reduced.