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

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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.

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Acknowledgements

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

Funding

None.

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Authors and Affiliations

  1. Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia

    Ljiljana Jovanovic, Milena Rajkovic & Vesna Subota

  2. Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Belgrade, Serbia

    Bojana Subotic, Boris Dzudovic & Slobodan Obradovic

  3. Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia

    Jovan Matijasevic & Marija Benic

  4. School of Medicine, University of Novi Sad, Novi Sad, Serbia

    Jovan Matijasevic

  5. Clinic of Cardiology, Clinical Center Nis, University of Nis, Nis, Serbia

    Sonja Salinger

  6. Clinic of Cardiology, Clinical Center Kragujevac, School of Medicine, University of Kragujevac, Kragujevac, Serbia

    Stefan Simovic & Vladimir Miloradovic

  7. Clinic of Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina

    Tamara Preradovic Kovacevic & Ljiljana Kos

  8. Department of Cardiology, Clinical Hospital Center Zemun, Belgrade, Serbia

    Aleksandar Neskovic & Srdjan Kafedzic

  9. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Aleksandar Neskovic & Natasa Markovic Nikolic

  10. University Clinical Center Zvezdara, School of Medicine, University of Belgrade, Belgrade, Serbia

    Natasa Markovic Nikolic

  11. Clinic of Cardiology, Clinical Center Podgorica, School of Medicine, University of Podgorica, Podgorica, Montenegro

    Bjanka Bozovic & Nebojsa Bulatovic

  12. School of Medicine, University of Defense, Belgrade, Serbia

    Nebojsa Bulatovic & Slobodan Obradovic

Authors
  1. Ljiljana Jovanovic
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  2. Milena Rajkovic
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  3. Vesna Subota
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  4. Bojana Subotic
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  5. Boris Dzudovic
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  6. Jovan Matijasevic
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  7. Marija Benic
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  8. Sonja Salinger
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  9. Stefan Simovic
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  10. Vladimir Miloradovic
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  11. Tamara Preradovic Kovacevic
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  12. Ljiljana Kos
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  13. Aleksandar Neskovic
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  14. Srdjan Kafedzic
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  15. Natasa Markovic Nikolic
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  16. Bjanka Bozovic
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  17. Nebojsa Bulatovic
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  18. Slobodan Obradovic
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Corresponding author

Correspondence to Slobodan Obradovic.

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Conflict of interest

The authors have no conflict of interests to declare.

Ethical approval

This research was approved by the ethical committee (No.152/2019) at the Military medical academy, Belgrade, Serbia, from where it is still coordinated. Every participating center is responsible for obtaining appropriate ethical approval and informed consent.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

This is non-interventional study, and all participants gave consent to be part of the registry without use of any uncovered personal data.

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Jovanovic, L., Rajkovic, M., Subota, V. et al. Predictive value of admission glycemia in diabetics with pulmonary embolism compared to non-diabetic patients. Acta Diabetol 59, 653–659 (2022). https://doi.org/10.1007/s00592-021-01843-2

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  • DOI: https://doi.org/10.1007/s00592-021-01843-2

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