The Impact of Changes in Fasting Plasma Glucose Before and After Heart Failure Diagnosis on All-Cause Mortality

Objective: This study evaluates the impact of fasting plasma glucose (FPG) changes before and after heart failure (HF) diagnosis on all-cause mortality, offering insights into personalized HF management strategies. Methods: A prospective cohort study based on the Kailuan study included 3533 Patients with HF after excluding those with prior HF, malignancies, or missing FPG data. FPG levels were measured before and after HF diagnosis and categorized into five groups: significant decrease (Q1), mild decrease (Q2), stable (Q3), mild increase (Q4), and significant increase (Q5). The primary endpoint was all-cause mortality, with follow-up until December 31, 2021. Results: Over a mean follow-up of 5.63±3.80 years, 1446 deaths occurred. Kaplan-Meier analysis showed increased mortality with larger FPG changes (P<0.0001). Multivariate Cox regression indicated higher mortality risks in Q1 and Q5 compared to Q3, with hazard ratios of 1.37 (95% CI: 1.12-1.67) and 1.35 (95% CI: 1.12-1.62), respectively. Conclusion: FPG changes before and after HF diagnosis are independent predictors of mortality, with significant changes linked to higher risks, underscoring the need for individualized glucose management in Patients with HF.