Glycated Hemoglobin and Outcomes of Heart Failure (from Get With the Guidelines-Heart Failure)

Justin B. Echouffo-Tcheugui, Shubin Sheng, Adam D. DeVore, Roland A. Matsouaka, Adrian F. Hernandez, Clyde W. Yancy, Paul A. Heidenreich, Deepak L. Bhatt, Gregg C. Fonarow*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Glycated hemoglobin (HbA 1C ) is a risk factor for new onset heart failure (HF). There is however a paucity of data evaluating its association with outcomes in patients with established HF. We assessed the relation of HbA 1C with outcomes among hospitalized HF patients. Among 41,776 HF patients from 263 hospitals participating to the Get with the Guidelines-HF registry between January 2009 and March 2016, we related HbA 1C to outcomes (in-hospital mortality, length of hospital stay, discharge to home, 30-day mortality, 30-day readmission, and 1-year mortality), using generalized estimating equation to account for within-hospital clustering and potential confounders. There were 68% of HF patients with diabetes and median HbA 1C was 7.1%. Each percent change in HbA 1C was associated with higher odds of discharge to home for HbA 1C levels <6.5% (covariate-adjusted odds ratio [OR] 1.13 [95% confidence interval 1.04 to 1.12]) or ≥6.5% (OR 1.05 [1.02 to 1.07]). After stratification by diabetes status, this association remained significant only among patients with diabetes (ORs for HbA 1C levels <6.5%: 1.17 [1.07 to 1.27]; and ≥6.5%: 1.06 [1.03 to 1.09]). Compared with the lowest HbA 1C tertile (HbA 1C ≤6.1%), patients in the highest HbA 1C tertile (HbA 1C 7.3% to 19%) were more likely to have a length of hospital stay >4 days (OR 1.10 [1.02 to 1.18]) and to be discharged home (OR 1.23 [1.14 to 1.33]). There were no significant association between HbA 1C and the following outcomes: in-hospital mortality, 30-day mortality, 30-day readmission, and 1-year mortality. In conclusion, among hospitalized HF patients, HbA 1C was associated with prolonged hospital stay and home discharge, but not with readmission, short-term, or intermediate-term mortality.

Original languageEnglish (US)
Pages (from-to)618-626
Number of pages9
JournalAmerican Journal of Cardiology
Volume123
Issue number4
DOIs
StatePublished - Feb 15 2019

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Echouffo-Tcheugui, J. B., Sheng, S., DeVore, A. D., Matsouaka, R. A., Hernandez, A. F., Yancy, C. W., Heidenreich, P. A., Bhatt, D. L., & Fonarow, G. C. (2019). Glycated Hemoglobin and Outcomes of Heart Failure (from Get With the Guidelines-Heart Failure). American Journal of Cardiology, 123(4), 618-626. https://doi.org/10.1016/j.amjcard.2018.11.023