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Association of fasting blood glucose variability with all-cause mortality in heart transplant recipients

Qiang Zheng1, Xing Liu1, Hongwen Lan1

  • 1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Clinical Transplantation
|April 4, 2023
PubMed

Insights

High fasting blood glucose (FBG) variability is a significant predictor of mortality in heart transplant recipients. This glycemic marker independently increases the risk of death after transplantation, highlighting its prognostic value.

Area of Science:

  • Cardiology
  • Endocrinology
  • Transplantation Medicine

Background:

  • Fasting blood glucose (FBG) variability is an emerging glycemic control marker linked to cardiovascular events and mortality in general populations.
  • Its independent association with all-cause mortality in heart transplant recipients remains unestablished.

Purpose of the Study:

  • To investigate the independent association between FBG variability and all-cause mortality in adult heart transplant recipients.
  • To determine if FBG variability serves as a prognostic marker in this patient cohort.

Main Methods:

  • Retrospective cohort study of 373 adult heart transplant recipients surviving at least 1 year post-transplant.
  • FBG measured >3 times within the first year; variability assessed using coefficient of variation.
  • Multivariable-adjusted Cox regression analyses performed to evaluate mortality risk.

Main Results:

  • Patients categorized into FBG variability groups: ≤7.0%, 7.0%-13.5%, and >13.5%.
  • During median 44.4 months follow-up, 31 (8.3%) participants died.
  • High FBG variability (>13.5%) was significantly associated with increased all-cause mortality (HR: 2.75; p=0.004) after multivariable adjustment.

Conclusions:

  • Elevated FBG variability is a strong and independent predictor of all-cause mortality post-heart transplantation.
  • FBG variability represents a novel risk factor and prognostic indicator for heart transplant recipients.
  • Monitoring FBG variability may aid in risk stratification and management of heart transplant patients.
Abstract

Keywords:
all-cause mortalitycoefficient of variationfasting blood glucose variabilityheart transplantation

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