Diabetes and mortality of the patients supported by LVAD (left ventricular assist device)

Objective: Type 2 diabetes mellitus (DM) is a frequent co-morbidity among patients suffering from the advanced heart failure and undergoing Left Ventricular Assist Device (LVAD) implantation. The aim of the study was to evaluate the impact of type 2 DM on the early- and long-term outcomes of patients who underwent LVAD implantation. Methods: We performed an observational cohort study in the large tertiary center during 14 years. All data of patients who underwent continuous flow LVAD implantation, performed between 2006 and 2020 were extracted from the departmental database. Patients were divided into two groups: Group I (non-diabetic patients), and Group II (diabetic patients).

Results: The study population includes 154 patients. Group I (non-diabetic patients), comprise 88 patients, and Group II (diabetic patients), comprise 66 patients. Mean follow-up duration was 38.2±30.3 months. In-hospital mortality was similar between Group I and II (9.8% vs. 16.1%, p=0.312). Short- and intermediate-term mortality (1- and 3-year) was higher in the DM group compared with the non-DM group, but did not reach statistical significance: 24.2% vs. 17.3% (p = 0.399) and 30.6% vs. 21.9% (p = 0.127) respectively. Long-term, 5-year mortality was significantly higher in the DM group, compared to the non-DM group: 38.7% vs. 24.4% (p = 0.038). Conclusions: Diabetic and non-diabetic patients have similar in-hospital mortality short- and intermediate-term mortality rates. Survival of diabetic patients started deteriorates after more than three year follow surgery. Type 2 DM is an independent predictor for long-term mortality after LVAD surgery.