Predictors of readmission and mortality in patients with decompensated heart failure according to glycaemic status

Abstract

Aims: The aim of the study was to evaluate the predictors of rehospitalization and all-cause mortality in patients with normoglycaemia, prediabetes and diabetes admitted with decompensated heart failure (HF). Methods: This was a retrospective cohort study of patients admitted with a primary diagnosis of HF. The study population included all patients with HbA1c value available at admission during the first 6 months of 2015 (n=311). Other patient variables were also characterised. The primary outcome of interest was the composite of time to readmission for HF or all-cause mortality. Results: The mean age of the study population was 77.8±10.8 years, 44.1% were male. Sixteen percent had normoglycaemia, 19% had prediabetes and 65% had diabetes. Older age, higher New York Heart Association (NYHA) class, atrial fibrillation (AF), lower total cholesterol levels, use of loop diuretics and mineralocorticoid antagonists were predictors of the primary outcome. Glycaemic status did not significantly predict the risk of the composite outcome. There was an effect modification of the association of sex and AF with the primary outcome, according to the glycaemic profile. The risk of readmission for HF or mortality was higher among women with normoglycaemia; and the risk was also higher among patients with AF with normoglycaemia or diabetes (but not prediabetes). Conclusions: Older Patients, with higher NYHA class, with diagnosis of AF and with lower total cholesterol levels are at increased risk of readmission for HF or mortality irrespective of glycemic status. Female sex was a predictor of higher risk only in normoglycemia