Heart failure

Elevated Blood Sugar Tied to Early Death in Heart Failure Patients

Patients who arrive to the emergency department with acute heart failure should have their blood sugar levels checked, according to a new study. This simple measurement could help practitioners better identify patients at high-risk for death, hospitalization, or additional comorbidities.

For the analysis, researchers looked at a total of 16,524 patients (aged 70-85) who arrived at hospital emergency departments in Ontario, Canada between 2004 and 2007.

Researchers used a control group of patients with a blood glucose level between 3.9 mmol/L and 6.1 mmol/L for reference.

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Patients Without Diabetes

About 56% or 9275 patients did not have pre-existing diabetes upon arrival to the ED.     

Researchers found that:

  • A blood glucose level between 6.1 mmol/L and 7.8 mmol/L upon arrival, but without pre-existing diabetes, translated to a 26% higher risk of death from any cause and a 28% higher risk of death from cardiovascular causes within 30 days. The risk of diabetes was 61% higher.
  • A blood glucose level >11.1 mmol/L upon arrival, but without pre-existing diabetes, meant a 50% higher risk of death from any cause and a 261% higher risk for diabetes. A blood glucose level between 9.4 mmol/L and 11.1 mmol/L denoted a 64% higher risk of death from cardiovascular causes within 30 days.
  • The risk of diabetes increased 14% for every 1 mmol/L increase in blood sugar.

“Although diabetes is a known risk factor for developing heart failure, this is the first time that it has been shown that heart failure predisposes people to developing diabetes,” said Douglas Lee, MD, PhD, associate professor of medicine and senior scientist at the Institute for Clinical Evaluative Sciences. 

Patients With Diabetes

In the same analysis, researchers also looked at 7249 patients who arrived to the ED with pre-existing diabetes.

Researchers found that:

  • A blood glucose level >11.1 mmol/L upon arrival translated to a 48% increase in risk of death from any cause and a 39% increased risk of being hospitalized for diabetes-related complications, such as hyperglycemia, skin and soft tissue infections, and amputations.
  • A blood glucose level  >9.4 mmol/L, with or without diabetes, increased the risk of hospitalization for heart failure or cardiovascular causes by 9% to 15%.

—Pooja Shah

References:

  1. European Society of Cardiology. Blood sugar levels in heart failure patients predict risk of early death, hospitalizations and diabetes [press release]. January 7, 2015. www.escardio.org/about/press/press-releases/pr-15/Pages/glucose-heart-failure-predict-death.aspx?hit=dontmiss. Accessed January 7, 2015.
  2. Sud M, et al. Presentation blood glucose and death, hospitalization, and future diabetes risk in patients with acute heart failure syndromes. Eur Heart J. doi:10.1093/eurheartj/ehu462.