TY - JOUR
T1 - Altered fasting glycemia in cardiac patients during in-hospital rehabilitation
T2 - impact on short and long-term follow-up
AU - Masnaghetti, Sergio E.
AU - Sarzi Braga, Simona
AU - Vaninetti, Raffaella
AU - Baiardi, Paola
AU - Pedretti, Roberto F E
PY - 2017/8
Y1 - 2017/8
N2 - BACKGROUND AND AIMS: Hospitalized patients after acute cardiovascular events have poorer prognosis if glucose regulation is diagnosed as abnormal. We compared the short and long-term outcome of patients with newly diagnosed altered fasting glycemia (AFG) to that of known diabetic patients and patients with normal glucose regulation (NGR) after admission to cardiac rehabilitation. METHODS: We retrospectively analyzed 2490 consecutive patients. Three groups were identified: known diabetes mellitus (n?=?540, 22%), fasting glycemia above 110?mg/dl (AFG, n?=?269, 11%), and fasting glycemia 110?mg/dl or less (NGR, n?=?1681, 67%). Clinical variables, complications, and all-cause mortality were evaluated. RESULTS: At follow-up (median 3.1?±?2.4 years), after adjustment for age, sex, BMI, left ventricular ejection fraction, history of coronary artery disease, AFG had a significantly longer hospital stay versus NGR (21?±?8 versus 20?±?8 days; P?=?0.019) and higher risk of paroxysmal atrial fibrillation (P?=?0.041), pleural/pericardial effusions (P?<?0.001), skin complications (P?=?0.033), other events (P?=?0.001), and blood tests (urea: P?=?0.007; white blood cells: P?=?0.002; neutrophils: P?<?0.001; creatinine: P?=?0.022). All-cause mortality was significantly higher in diabetes mellitus versus NGR (odds ratio 1.61, 95% confidence interval 1.17–2.21); a nonsignificant trend was observed in AFG versus NGR (odds ratio 1.23, 95% confidence interval 0.77–1.98). CONCLUSIONS: A high AFG prevalence in cardiac patients admitted to rehabilitation was observed. AFG patients were more vulnerable than NGR patients, had higher complication rates independently of covariates, and required longer hospital stay. AFG was not a significant predictor of all-cause mortality at 3 years, whereas DM was.
AB - BACKGROUND AND AIMS: Hospitalized patients after acute cardiovascular events have poorer prognosis if glucose regulation is diagnosed as abnormal. We compared the short and long-term outcome of patients with newly diagnosed altered fasting glycemia (AFG) to that of known diabetic patients and patients with normal glucose regulation (NGR) after admission to cardiac rehabilitation. METHODS: We retrospectively analyzed 2490 consecutive patients. Three groups were identified: known diabetes mellitus (n?=?540, 22%), fasting glycemia above 110?mg/dl (AFG, n?=?269, 11%), and fasting glycemia 110?mg/dl or less (NGR, n?=?1681, 67%). Clinical variables, complications, and all-cause mortality were evaluated. RESULTS: At follow-up (median 3.1?±?2.4 years), after adjustment for age, sex, BMI, left ventricular ejection fraction, history of coronary artery disease, AFG had a significantly longer hospital stay versus NGR (21?±?8 versus 20?±?8 days; P?=?0.019) and higher risk of paroxysmal atrial fibrillation (P?=?0.041), pleural/pericardial effusions (P?<?0.001), skin complications (P?=?0.033), other events (P?=?0.001), and blood tests (urea: P?=?0.007; white blood cells: P?=?0.002; neutrophils: P?<?0.001; creatinine: P?=?0.022). All-cause mortality was significantly higher in diabetes mellitus versus NGR (odds ratio 1.61, 95% confidence interval 1.17–2.21); a nonsignificant trend was observed in AFG versus NGR (odds ratio 1.23, 95% confidence interval 0.77–1.98). CONCLUSIONS: A high AFG prevalence in cardiac patients admitted to rehabilitation was observed. AFG patients were more vulnerable than NGR patients, had higher complication rates independently of covariates, and required longer hospital stay. AFG was not a significant predictor of all-cause mortality at 3 years, whereas DM was.
UR - http://www.scopus.com/inward/record.url?scp=84991510914&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991510914&partnerID=8YFLogxK
U2 - 10.2459/JCM.0000000000000478
DO - 10.2459/JCM.0000000000000478
M3 - Article
AN - SCOPUS:84991510914
SP - 625
EP - 630
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
ER -