Impact of diabetes mellitus on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic valve stenosis.

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Impact of diabetes mellitus on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic valve stenosis.

Hellenic J Cardiol. 2017 Aug 11;:

Authors: Tokarek T, Dziewierz A, Wiktorowicz A, Bagienski M, Rzeszutko L, Sorysz D, Kleczynski P, Dudek D

Abstract
BACKGROUND: Diabetes mellitus (DM) has been considered as a marker of poor prognosis after cardiac surgery. We sought to investigate the impact of DM on clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI).
METHODS: A total of 148 consecutive patients with symptomatic, severe aortic stenosis who underwent TAVI were included. Baseline characteristics, procedural and long-term clinical outcomes as well as the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM.
RESULTS: Diabetes mellitus was present in 48 of 148 (32.4%) patients. No differences in periprocedural risk (Logistic Euroscore and STS) between groups were observed. There were no differences in 30-day and 12-month all-cause mortality between groups [DM(-) vs. DM(+): 7 (7.0%) vs. 5 (10.4%);p=0.53 and 12 (12.0%) vs. 10 (20.8%);p=0.16, respectively]. No influence of DM presence on the risk of death was confirmed after adjustment for age and gender(for 30-day mortality age/gender adjusted OR 1.55, 95%CI 0.47-5.17; for 12-month mortality age/gender adjusted OR 2.05, 95%CI 0.79-5.32). Similarly, at the longest available follow-up mortality did not differ between groups [14 (29.2%) vs. 19 (19.0%);p=0.16; age/gender adjusted OR 1.81, 95%CI 0.80-4.08]. Similar rates of other complications after TAVI were noted. Frailty measured with 5-meter walking test was more frequently reported in patients with DM [11 (22.9%) vs. 10 (10.0%);p=0.035]. No differences in QoL parameters at baseline and 12 months were noted.
CONCLUSIONS: Patients with DM undergoing TAVI demonstrated similar mortality, complications rate and QoL outcomes as compared to patients without DM.

PMID: 28807801 [PubMed - as supplied by publisher]

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