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Abstract：
Background Acute decompensated heart failure (ADHF) significantly contributes to global morbidity. Stress hyperglycemia (SHGL), although commonly observed in non-diabetic ADHF patients, remains underexplored. This study investigates the predictive value of SHGL for major adverse cardiac events (MACEs) and its impact on coronary intervention outcomes. Methods In this prospective observational study at a tertiary care center, 650 non-diabetic ADHF patients admitted for coronary intervention between April 2021 and April 2022 were assessed. SHGL was defined by random blood sugar levels >140 mg/dl. We monitored the incidence of MACEs, including cardiac death, non-fatal myocardial infarction, and heart failure rehospitalization, alongside the success rates of coronary revascularizations over 12 months. Results SHGL was present in 54% of patients (n=352) and was significantly associated with increased MACEs (p<0.001), higher rehospitalization rates (p<0.01), and lower success in revascularization (p<0.05). Using logistic regression, SHGL, age >65, and prior heart failure hospitalization were identified as independent predictors of MACEs. Statistical analyses were performed using two-tailed Mann-Whitney U tests, with significance levels set at p<0.05 for noteworthy findings and p<0.01 or p<0.001 for highly significant findings. Conclusions SHGL significantly impacts coronary intervention outcomes and the future prognosis of heart failure in non-diabetic ADHF patients, identifying it as a critical, modifiable risk factor. These findings advocate integrating SHGL management into ADHF care, emphasizing the need for further research to develop standardized treatment protocols. Proper management of SHGL could potentially improve patient outcomes, highlighting the importance of metabolic control in heart failure management.
摘要：
背景：急性失代偿性心力衰竭（ADHF）是全球发病率的重要因素。应激性高血糖（SHGL），尽管通常在非糖尿病ADHF患者中观察到，仍未充分开发。这项研究调查了SHGL对主要不良心脏事件（MACE）的预测价值及其对冠状动脉介入治疗结果的影响。方法在这项在三级护理中心进行的前瞻性观察研究中，对2021年4月至2022年4月期间接受冠状动脉介入治疗的650例非糖尿病ADHF患者进行了评估。SHGL定义为随机血糖水平>140mg/dl。我们监测了MACEs的发生率，包括心脏死亡,非致死性心肌梗死,心力衰竭再住院，除了12个月以上冠状动脉血运重建的成功率。结果54％的患者存在SHGL（n=352），并且与MACE增加显着相关（p<0.001），较高的再住院率(p<0.01)，血运重建成功率较低(p<0.05)。使用逻辑回归，SHGL,年龄>65岁和既往心力衰竭住院被确定为MACEs的独立预测因子.使用双尾Mann-WhitneyU检验进行统计分析，对于值得注意的发现，显著性水平设置为p<0.05，对于高度显著的发现，p<0.01或p<0.001。结论SHGL显著影响非糖尿病ADHF患者的冠状动脉介入治疗结果和未来心力衰竭的预后。认为它是一个关键的，可修改的风险因素。这些发现主张将SHGL管理整合到ADHF护理中，强调需要进一步研究以制定标准化的治疗方案。正确管理SHGL可能会改善患者的预后，强调代谢控制在心力衰竭管理中的重要性。
