Article ; Online: Impact of hypoglycemia at the time of hospitalization for heart failure from emergency department on major adverse cardiovascular events in patients with and without type 2 diabetes.
2022 Volume 21, Issue 1, Page(s) 218
Abstract: Background: Few studies have examined the association between hypoglycemic episodes among people with type 2 diabetes (T2DM) at the time of hospitalization for heart failure (HF) and cardiovascular outcomes.: Methods: From March 2016 to June 2018, we ...
| Abstract | Background: Few studies have examined the association between hypoglycemic episodes among people with type 2 diabetes (T2DM) at the time of hospitalization for heart failure (HF) and cardiovascular outcomes. Methods: From March 2016 to June 2018, we conducted a retrospective cohort study to investigate hypoglycemia during HF hospitalization in the emergency department, three-point major adverse cardiovascular events (3P-MACE), and all-cause mortality; these were followed up through June 2021. HF hospitalization was defined according to American Heart Association criteria. Hypoglycemia was defined as a glucose level < 3.9 mmol/L at the time of HF hospitalization. We classified the enrolled patients into three groups (reference group, those without T2DM or hypoglycemia; those diagnosed with T2DM without hypoglycemia; and those with hypoglycemia and T2DM). We used Cox proportional hazard regression analysis to investigate the association between the three groups and the development of the first occurrence of 3P-MACE and all-cause mortality. Results: During a median of 25 months of follow-up, a total of 783 patients admitted due to HF were analyzed. In total, 159 (20.3%) cases of 3P-MACE were identified, and the mortality rate was 20.2% (n = 158). The median age of patients was 76.0 (65.0-82.0) years, and 49.0% were men. Patients with 3P-MACE had a lower body mass index (22.6 [20.4-25.1] vs. 23.8 [21.3-26.7]), higher frequency of previous history of HF (24.5% vs. 15.7%), T2DM (64.2% vs. 47.3%), higher rates of hypoglycemia at the time of HF hospitalization (19.5% vs. 7.7%), and lower eGFR levels (61.1 [36.0-80.7] mL/min/1.73 m<sup>2</sup> vs. 69.2 [45.8-89.5] mL/min/1.73 m<sup>2</sup>) than those without 3P-MACE. The multivariable adjusted HR of 3P-MACE was as follows: group with hypoglycemia and T2DM: HR, 2.29; 95% CI: 1.04-5.06; group with T2DM without hypoglycemia: HR: 1.42; 95% CI: 0.86-2.33; and all-cause mortality group with hypoglycemia and T2DM: HR: 2.58; 95% CI: 1.26-5.31, group with T2DM without hypoglycemia: HR: 1.32; 95% CI: 0.81-2.16; compared to the reference group (group without T2DM or hypoglycemia). Conclusions: T2DM and hypoglycemia are independent risk factors for 3P-MACE and all-cause mortality compared to those without hypoglycemia during HF hospitalization. |
|---|---|
| MeSH term(s) | Male ; Humans ; Aged ; Aged, 80 and over ; Female ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/epidemiology ; Retrospective Studies ; Hypoglycemia/diagnosis ; Hypoglycemia/therapy ; Hypoglycemia/chemically induced ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Heart Failure/therapy ; Hospitalization ; Hypoglycemic Agents/adverse effects ; Emergency Service, Hospital ; Glucose ; Cardiovascular Diseases/epidemiology |
| Chemical Substances | Hypoglycemic Agents ; Glucose (IY9XDZ35W2) |
| Language | English |
| Publishing date | 2022-10-21 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2093769-6 |
| ISSN | 1475-2840 ; 1475-2840 |
| ISSN (online) | 1475-2840 |
| ISSN | 1475-2840 |
| DOI | 10.1186/s12933-022-01651-0 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.