@article{40d607e1b8d748a7b9ea4d409c9db4df,
title = "Routine use of HbA1c amongst inpatients hospitalised with decompensated heart failure and the association of dysglycaemia with outcomes",
abstract = "Diabetes is an independent risk factor for development of heart failure and has been associated with poor outcomes in these patients. The prevalence of diabetes continues to rise. Using routine HbA1c measurements on inpatients at a tertiary hospital, we aimed to investigate the prevalence of diabetes amongst patients hospitalised with decompensated heart failure and the association of dysglycaemia with hospital outcomes and mortality. 1191 heart failure admissions were identified and of these, 49% had diabetes (HbA1c ≥ 6.5%) and 34% had pre-diabetes (HbA1c 5.7–6.4%). Using a multivariable analysis adjusting for age, Charlson comorbidity score (excluding diabetes and age) and estimated glomerular filtration rate, diabetes was not associated with length of stay (LOS), Intensive Care Unit (ICU) admission or 28-day readmission. However, diabetes was associated with a lower risk of 6-month mortality. This finding was also supported using HbA1c as a continuous variable. The diabetes group were more likely to have diastolic dysfunction and to be on evidence-based cardiac medications. These observational data are hypothesis generating and possible explanations include that more diabetic patients were on medications that have proven mortality benefit or prevent cardiac remodelling, such as renin-angiotensin system antagonists, which may modulate the severity of heart failure and its consequences.",
author = "K. Khoo and J. Lew and P. Neef and L. Kearney and L. Churilov and R. Robbins and A. Tan and M. Hachem and L. Owen-Jones and Q. Lam and Hart, {G. K.} and A. Wilson and P. Sumithran and D. Johnson and Srivastava, {P. M.} and O. Farouque and Burrell, {L. M.} and Zajac, {J. D.} and Ekinci, {E. I.}",
note = "Funding Information: K.K. and E.I.E. initiated the study, participated in its design, conception, and co-ordination, helped in the collection of data for analysis and interpretation, drafting and editing of the article. J.L. performed statistical analysis and P.N. assisted with data collection. L.K. contributed to conception and design of the study and assisted with interpretation of echocardiographic data. L.C. contributed to the conception and design of the study, performed statistical analysis and drafting and editing of the article. R.R., A.T., L.O.-J., Q.L., A.W. and G.H. contributed to the design of the study. D.J., O.F. and L.B. contributed to the design of the study, interpretation of data and editing of the article. M.H., P.S. and P.M.S. assisted with drafting and editing of the article. J.Z. contributed to the design of the study, analysis of data, and editing of the article. All authors read and approved the final manuscript. E.I.E. was supported by an NHMRC Early Career Fellowship, a Viertel Clinical Investigatorship, RACP Fellowship, Sir Edward Weary Dunlop Medical Research Foundation research grant, and an unconditional Takeda Pharmaceuticals grant. Publisher Copyright: {\textcopyright} 2018, The Author(s).",
year = "2018",
month = sep,
day = "10",
doi = "10.1038/s41598-018-31473-8",
language = "English",
volume = "8",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",
}
