High Hemoglobin Glycation Index Linked to Increased Mortality in Heart Failure, reveals research

HGI is the observed-predicted difference for hemoglobin A1c (HbA1c) values. HbA1c has gained popularity in the management of diabetes, but it has not yet been explained completely in the context of HF prognosis. The aim of this study is to define the association between HGI and mortality in HF patients who are admitted to the ICU.

This study was conducted with a retrospective analysis of data from the MIMIC-IV database. The patients included in the study were previously admitted to intensive care for HF. A linear regression model was formulated to estimate predicted HbA1c from fasting blood glucose (FBG). The HGI value was established by the observed minus the predicted HbA1c. The major endpoints were 30 and 365-day all-cause mortality after admission.

Kaplan–Meier survival curves were utilized to contrast mortality rates between various HGI groups. Cox regression models and restricted cubic spline (RCS) analysis were used to evaluate the association between HGI and mortality risk. Subgroup and sensitivity analyses were used to confirm the results.

Key Findings

• 2,846 HF patients (40.1% male) were included.

• 10.7% (305 patients) of them died within 30 days, and 33.5% (954 patients) of them died within 365 days.

• Kaplan–Meier analysis also showed that a high HGI was significantly correlated with higher risk of mortality (log-rank P < 0.001).

• Those who had high HGI were significantly at a higher risk of 30-day (adjusted hazard ratio [aHR]: 2.36, 95% CI: 1.74–3.20, P < 0.001) and 365-day (aHR: 1.40, 95% CI: 1.16–1.68, P < 0.001) mortality.

• Every one-point rise in HGI was associated with 1.42-fold increased risk of 30-day mortality (aHR: 1.42, 95% CI: 1.28–1.57, P < 0.001) and 1.19-fold increased risk of 365-day mortality (aHR: 1.19, 95% CI: 1.11–1.68, P < 0.001).

• RCS analysis revealed an L-shaped nonlinear relationship between HGI and mortality (P for nonlinearity < 0.001), with an inflection point at HGI = -1.295.

• A high HGI value (> 0.709) was identified as a threshold for increased risk of mortality.

The study authors concluded that in critically ill heart failure patients admitted to ICU, high hemoglobin glycation index was strongly correlated with short-term and long-term mortality risks. The results indicate that HGI has the potential to be a useful prognostic indicator in clinical practice, facilitating the detection of high-risk patients and the best treatment strategies to maximize survival rates.

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