Impact of admission hyperglycaemia on clinical outcomes in non-diabetic heart failure with preserved ejection fraction

Aims: At present, the clinical significance of admission hyperglycaemia in heart failure with preserved ejection fraction (HFpEF) patients remains unknown. This study was designed to evaluate the relationship between admission hyperglycaemia and clinical outcome in HFpEF patients, especially in non-diabetic patients. Methods and results: We enrolled 486 non-diabetic HFpEF (left ventricular ejection fraction ≥50%) patients hospitalized due to acute decompensated heart failure from the PURSUIT-HFpEF registry, a prospective, multicentre observational study. We divided non-diabetic patients into two groups, an admission hyperglycaemia group whose blood glucose on admission was ≥7.0 mmol/L (148 patients) and a normoglycaemic group whose blood glucose on admission was <7.0 mmol/L (338 patients). The primary endpoint was all-cause mortality, and the secondary endpoints were heart failure death and other causes of cardiac death. During a mean follow-up period of 400 ± 335 days, all-cause mortality was 69 patients. Twenty-five patients suffered cardiac death. All-cause mortality (P = 0.002), cardiac death (P = 0.009), and heart failure death (P = 0.001) were significantly more frequent in the admission hyperglycaemia group than in the normoglycaemic group. Admission hyperglycaemia was independently and significantly associated with all-cause mortality and cardiac death (HR 2.01, 95% CI 1.20–3.34, P = 0.008 and HR 3.03, 95% CI 1.35–6.96, P = 0.007, respectively). Conclusions: Non-diabetic HFpEF patients with admission hyperglycaemia when hospitalized for heart failure had poorer clinical outcomes than normoglycaemic patients.