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Acta DiabetologicaVolume 59, Issue 5, May 2022, Pages 653-659

Predictive value of admission glycemia in diabetics with pulmonary embolism compared to non-diabetic patients(Article)

  • Jovanovic, L.,
  • Rajkovic, M.,
  • Subota, V.,
  • Subotic, B.,
  • Dzudovic, B.,
  • Matijasevic, J.,
  • Benic, M.,
  • Salinger, S.,
  • Simovic, S.,
  • Miloradovic, V.,
  • Kovacevic, T.P.,
  • Kos, L.,
  • Neskovic, A.,
  • Kafedzic, S.,
  • Nikolic, N.M.,
  • Bozovic, B.,
  • Bulatovic, N.,
  • Obradovic, S.
  • View Correspondence (jump link)
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  • aInstitute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia
  • bClinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia
  • cInstitute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
  • dSchool of Medicine, University of Novi Sad, Novi Sad, Serbia
  • eClinic of Cardiology, Clinical Center Nis, University of Nis, Nis, Serbia
  • fClinic of Cardiology, Clinical Center Kragujevac, School of Medicine, University of Kragujevac, Kragujevac, Serbia
  • gClinic of Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • hDepartment of Cardiology, Clinical Hospital Center Zemun, Belgrade, Serbia
  • iFaculty of Medicine, University of Belgrade, Belgrade, Serbia
  • jUniversity Clinical Center Zvezdara, School of Medicine, University of Belgrade, Belgrade, Serbia
  • kClinic of Cardiology, Clinical Center Podgorica, School of Medicine, University of Podgorica, Podgorica, Montenegro
  • lSchool of Medicine, University of Defense, Belgrade, Serbia

Abstract

Aims: To examine the relationship between admission glucose (AG) level and short-term in-hospital mortality and to investigate the association between hyperglycemia and major bleeding in PE patients with and without DMT2. Methods: We evaluated 1165 patients with diagnosed acute PE with multi-detector computed tomography pulmonary angiography (MDCT-PA) enrolled in the Regional multicenter PE registry (REPER). The study population was classified to patients with diabetes mellitus type 2 (DMT2) and those without diabetes. According to quartiles of AG patients, both groups separately were categorized into four subgroups (DMT2 I: < 7.5 mmol/L; II: 7.5–10.0 mmol/L; III: 10.0–15.7 mmol/L; IV: > 15.7 mmol/L and (non-DMT2 I: < 5.5 mmol/L; II: 5.5–6.3 mmol/L; III: 6.3–7.9 mmol/L; IV: > 7.9 mmol/L). Results: All-cause mortality was higher in the DMT2 group (9.5% vs. 18.2%, p < 0.001), and PE-cause mortality was 6% for the patients without DMT2 and 12.4% for DMT2 patients (p = 0.02). The patients in the fourth AG quartiles in both groups, without DMT2 and with DMT2, had significantly higher all-cause and PE-cause in-hospital mortality compared with the first quartile. Rates of major bleeding were similar between the groups. On the multivariable analysis, after adjusting for age, gender and mortality risk, the adherence in the fourth AG quartile had an independent predictive value for all-cause death (HR 2.476, 95% CI 1.017–6.027) only in DM patients. Conclusion: In our cohort of patients with acute PE, diabetes was associated with increased rates for all-cause and PE-cause mortality. © 2021, Springer-Verlag Italia S.r.l., part of Springer Nature.

Author keywords

Admission glucoseDiabetesMajor bleedingMortalityPulmonary embolism

Indexed keywords

EMTREE drug terms:glucose
EMTREE medical terms:adultagedagingall cause mortalityArticlebleedingcohort analysiscomparative studycomputed tomography pulmonary angiographycontrolled studydiabetes mellitusdisease registryfemaleglucose blood levelhospital admissionhumanhyperglycemiain-hospital mortalitylung embolismmajor clinical studymalemiddle agedmortality riskmultidetector computed tomographynon insulin dependent diabetes mellituspredictive valuesex ratioclinical trialcomplicationdiabetes mellitusglucose blood levelhospital mortalityhospitalizationhyperglycemiamulticenter studyprognosis
MeSH:Blood GlucoseDiabetes MellitusHospital MortalityHospitalizationHumansHyperglycemiaPrognosisPulmonary Embolism

Chemicals and CAS Registry Numbers:

glucose, 50-99-7, 84778-64-3;

Blood Glucose

Funding details

  • 1

    The authors would like to thank all participating centers of REPER registry, especially the collaborating centers in this investigation.

  • ISSN: 09405429
  • CODEN: ACDAE
  • Source Type: Journal
  • Original language: English
  • DOI: 10.1007/s00592-021-01843-2
  • PubMed ID: 35094143
  • Document Type: Article
  • Publisher: Springer-Verlag Italia s.r.l.

  Obradovic, S.; Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia;
© Copyright 2022 Elsevier B.V., All rights reserved.

Cited by 3 documents

Yin, X. , Pan, X. , Zhang, J.
Impact of admission glucose and 30-day major adverse cardiovascular events on patients with chest pain in an emergency setting: insights from the China EMPACT registry
(2024) Frontiers in Cardiovascular Medicine
Obradovic, S. , Dzudovic, B. , Matijasevic, J.
Regional registry of acute pulmonary embolism: Organization, aims, and achievements
(2023) Pulmonary Embolism: Contemporary Diagnosis, Risk Stratification and Management
Ding, C. , Guo, C. , Du, D.
Association between diabetes and venous thromboembolism: A systematic review and meta-analysis
(2023) Medicine (United States)
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