J Transcat Intervent.2019;27:eA20190007.
Assessment of the impact of diabetes mellitus on clinical outcomes after transcatheter aortic valve implantation
Diabetes mellitus is associated with increased mortality in patients undergoing surgical valve replacement. However, data on the impact of diabetes mellitus on the outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) are scarce and contradictory. The objective of this study was to investigate the impact of diabetes on clinical outcomes in the short and medium term in patients with severe aortic stenosis undergoing TAVI
This was a prospective single-center observational study which included patients with. aortic stenosis undergoing TAVI, between November 2008 and September 2018.
A total of 132 patients were included, of which 49 (37%) had diabetes mellitus and, of these, 10 (20%) were insulin dependent. Patients with diabetes mellitus were younger (77 years vs. 81 years; p<0.001) and had a more frequent history of coronary artery disease (63% vs. 41%; p=0.01) and a lower prevalence of chronic renal failure (44% vs. 63%; p=0.02). The presence of diabetes mellitus did not correlate with an increase in 30-day mortality in the clinical follow-up. There was also no difference between the groups in mortality rate due to cardiovascular causes (p=0.35), success of the procedure (96% vs. 93%; p=0.47), vascular complications (6% vs. 9%; p=0.85), life-threatening bleeding (4% vs. 10%; p=0.19), and length of hospital stay (8 vs. 7 days; p=0.40). However, diabetic patients treated with insulin showed increased mortality when compared to non-diabetics, and when compared to patients with non-insulin dependent diabetes mellitus.
The presence of diabetes mellitus did not influence outcome rates after TAVI, but patients with diabetes mellitus treated with insulin had a higher mortality rate in the medium-term follow-up.