0043Early Hyperglycemia Severity and 30-Day Outcomes in Patients With Diabetes Hospitalized for Heart Failure

Background In diabetes, early hyperglycemia during heart failure (HF) hospitalization may reflect acute metabolic stress and identify high-risk cardiometabolic physiology. Objective To evaluate whether first-24-hour hyperglycemia severity is associated with 30-day death or HF readmission among patients with diabetes hospitalized for HF without early hypoglycemia. Methods We performed a retrospective cohort study using MIMIC-IV v3.1. Adults with diabetes and a first qualifying HF hospitalization were included if 24-hour glucose data were available and no glucose <70 mg/dL occurred. Maximum glucose was categorized as <180, 180-249, or ≥250 mg/dL. Severe renal dysfunction was defined as creatinine ≥2.0 mg/dL. The primary outcome was all-cause death or HF readmission within 30 days. Logistic regression adjusted for age, sex, and severe renal dysfunction. Results Among 12,028 patients, 7,484 (62.2%) had glucose <180 mg/dL, 2,602 (21.6%) had glucose 180-249 mg/dL, and 1,942 (16.1%) had glucose ≥250 mg/dL. The 30-day event rate increased across categories (22.4%, 24.3%, and 30.4%), as did 30-day mortality (8.1%, 10.9%, and 15.4%). Compared with glucose <180 mg/dL, glucose 180-249 mg/dL (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01-1.25) and ≥250 mg/dL (OR 1.60, 95% CI 1.43-1.79) were associated with higher risk. Conclusions In patients with diabetes hospitalized for HF, early hyperglycemia showed a graded association with 30-day outcomes, particularly mortality. Severe hyperglycemia may represent a practical cardiometabolic risk marker before discharge. Is this an encore abstract? No