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Glycated Hemoglobin Variability Is Associated With Adverse Outcomes in Patients With Heart Failure Irrespective of

Xin Xu1,2, Qing-Wen Ren1,2, Chanchal Chandramouli3,4

  • 1Cardiology Division, Department of Medicine The University of Hong Kong-Shen Zhen Hospital Shenzhen China.

Journal of the American Heart Association
|April 30, 2024
PubMed

Insights

Glycated hemoglobin (HbA1c) variability increases risks for heart failure patients. This variability is linked to higher rehospitalization and death, especially in those without diabetes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • The impact of glycated hemoglobin (HbA1c) variability on adverse outcomes in heart failure (HF) patients remains unclear.
  • Understanding this relationship is crucial for managing HF patients, regardless of their diabetic status.

Purpose of the Study:

  • To investigate the predictive value of HbA1c variability for all-cause death and HF rehospitalization.
  • To assess these risks in HF patients irrespective of diabetes.

Main Methods:

  • Utilized a territory-wide clinical data registry for 65,950 HF patients.
  • Assessed HbA1c variability using average successive variability (ASV) or standard deviation (SD).
  • Employed multivariable Cox proportional hazards models to estimate adjusted hazard ratios (HR).

Main Results:

  • Increased HbA1c variability significantly correlated with higher HF rehospitalization (HR ASV, 1.20) and all-cause death (HR ASV, 1.50).
  • Diabetes status significantly modified the association (Pinteraction<0.001).
  • Patients with HF without diabetes showed a markedly higher risk of rehospitalization (HR ASV, 1.92) and death (HR ASV, 3.90) compared to those with diabetes.

Conclusions:

  • HbA1c variability is a significant predictor of rehospitalization and all-cause death in HF patients, independent of diabetes.
  • The adverse effects of HbA1c variability are more pronounced in HF patients without diabetes.
Abstract

Keywords:
HbA1c variabilitydiabetesheart failure

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