Altered fasting glycemia in cardiac patients during in-hospital rehabilitation: impact on short and long-term follow-up

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Abstract

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.

Original languageEnglish
Pages (from-to)625-630
Number of pages5
JournalJournal of Cardiovascular Medicine
DOIs
Publication statusPublished - Aug 2017

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Fasting
Rehabilitation
Glucose
Mortality
Length of Stay
Diabetes Mellitus
Odds Ratio
Confidence Intervals
Pericardial Effusion
Hematologic Tests
Pleural Effusion
Stroke Volume
Atrial Fibrillation
Urea
Coronary Artery Disease
Creatinine
Neutrophils
Leukocytes
Skin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{cfb14b91b1cc40839d87659958386c1e,
title = "Altered fasting glycemia in cardiac patients during in-hospital rehabilitation: impact on short and long-term follow-up",
abstract = "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.",
author = "Masnaghetti, {Sergio E.} and {Sarzi Braga}, Simona and Raffaella Vaninetti and Paola Baiardi and Pedretti, {Roberto F E}",
year = "2017",
month = "8",
doi = "10.2459/JCM.0000000000000478",
language = "English",
pages = "625--630",
journal = "Journal of Cardiovascular Medicine",
issn = "1558-2027",
publisher = "Lippincott Williams and Wilkins",

}

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.

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