Akirov A, et al. - This study assessed the prognostic significance of admission blood glucose (ABG) in hospitalized atrial fibrillation (AF) patients with and without diabetes mellitus (DM), presuming that hyperglycemia on admission is a bad prognostic marker in patients with AF. In both groups of patients, an association was observed, between moderately to markedly elevated ABG levels and increased mortality.

Methods

• Researchers collected observational data from electronic records of patients age ≥ 18 years hospitalized for AF in 2011–2013.
• They obtained 12-month data in all cases.
• ABG levels were classified as follows: 70 to 110 mg/dL, normal; 111 to 140 mg/dL, mildly elevated; 141 to 199 mg/dL, moderately elevated; ≥200 mg/dL, markedly elevated.
• They used Cox proportional hazards model to examine overall survival by ABG categories, adjusted for study variables.
• Mortality at end of follow-up was the primary outcome measure.

Results

• A total of 1127 patients (45% male; median age, 75 ± 13 years) were included in this cohort study, of whom 331 had DM.
• Researchers observed that mortality rates by ABG levels were 19% (77/407 patients), normal ABG; 26% (92/353 patients), mildly elevated ABG; 28% (69/244 patients), moderately elevated ABG; and 41% (50/123 patients), markedly elevated ABG.
• Furthermore, data were analyzed for the entire cohort following adjustment for age, sex, CHADS₂ score, ischemic heart disease, smoking, and alcohol consumption.
• Findings demonstrated that compared with normal ABG, the adjusted hazard ratio for mortality was higher in patients with moderately elevated ABG (2.1, 95% confidence interval: 1.19-7.94, P < 0.05) and markedly elevated ABG (1.6, 95% confidence interval: 1.02-5.31,P < 0.05).