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Impact of Diabetes Mellitus on Outcomes After Transcatheter Aortic Valve Implantation
- Source :
- The American journal of cardiology. 117(10)
- Publication Year :
- 2015
-
Abstract
- Several clinical variables have been identified as predictors of clinical outcome after transcatheter aortic valve implantation (TAVI). Nonetheless, there is limited and contradictive data on the impact of diabetes mellitus (DM) on the prognosis of patients who undergo TAVI. We aimed to investigate the clinical characteristics and the early and midterm outcomes after TAVI according to DM status. From 802 consecutive patients who underwent TAVI, we compared 548 patients with no DM to 254 patients with diabetes (177 orally treated and 77 insulin treated). Patients with DM were younger had higher body mass index and incidence of coronary artery disease and lower incidence of frailty. Device success, 30-day mortality and major complications rates were similar between groups. One-year mortality was 12.1% for patient with DM and 12.2% for patients without DM (p = 0.91). In a multivariable regression analysis including age, body mass index, coronary artery disease and frailty, DM was associated with decreased overall survival. This was driven by increased overall mortality of the insulin-treated DM subgroup (hazard ratio 2.40, 95% CI 1.32 to 4.37; p0.01). In conclusion, DM does not affect short-term mortality or rates of complications after TAVI. Insulin-treated DM, but not orally treated DM, is independently associated with death at midterm follow-up and therefore aggressive cardiovascular risk factor modification as well as intense glycemic control should be considered for patients with insulin-treated DM with severe aortic stenosis who undergo TAVI.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
Risk Assessment
California
Coronary artery disease
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Internal medicine
Diabetes mellitus
medicine
Humans
030212 general & internal medicine
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Incidence (epidemiology)
Insulin
Incidence
Hazard ratio
Retrospective cohort study
Aortic Valve Stenosis
medicine.disease
Prognosis
Survival Rate
Treatment Outcome
Diabetes Mellitus, Type 2
Aortic Valve
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Risk assessment
Body mass index
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 117
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....fca0c320ad0ca4c27f36f0adb4515045