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La variabilité glycémique et l’hyperglycémie sont des marqueurs pronostiques de la survenue d’événements cardiovasculaires majeurs chez les patients diabétiques hospitalisés en unité de soins intensifs cardiologiques pour insuffisance cardiaque aigue

Year: 2022
Type: dissertation
Study design: Observational Study
Abstract: 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). 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 hospitalization 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. 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) (HR of 3.16 (2.25–4.43; p < 0.001)) was the strongest independent predictor of MACE. Conclusions: 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.
Source: HAL
Author: Bouchard de la Poterie, Ambroise
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7010875376
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