Impact of Diabetes Mellitus on Early and Midterm Outcomes Following Transcatheter Aortic Valve Implantation/p>

Ehud Chorin Ariel Finkelstein Shmuel Banai Leehee Barak Gad Keren Arie Steinvil
Department of Cardiology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Israel

Transcatheter aortic valve implantation (TAVI) is considered a suitable treatment for patients with severe symptomatic aortic stenosis (AS) and high operative risk. Several clinical and procedural factors have been identified as predictors of early and midterm events after TAVI, but incidence and prognostic impact of diabetes mellitus (DM) on outcomes remain to be defined. In the present study, 586 consecutive patients who underwent TAVI at our institutions were enrolled and stratified according to DM status. All-cause mortality at 30 days or in hospital and at follow-up was the primary end point, whereas periprocedural complications, rates of myocardial infarction, stroke, and reintervention at follow-up were the secondary ones. All end points were adjudicated according to the Valve Academic Research Consortium definitions. In all, 586 patients were enrolled: 374 without DM and 212 with DM. Thirty-day mortality was not significantly higher in patients with DM compared with patients without diabetes (3.3% vs 2.7% p = 0.670). Bleedings, vascular complications, post procedural acute kidney injury, and periprocedural strokes were not significantly different in the two groups. In a subanlysis of DM patients, complications were not significantly higher in patients with orally treated DM compared to insulin-treated DM. At 1 year follow-up, patients with DM had a non-significantly higher mortality rate (17.1% vs 12.9%, p = 0.223) if compared with patients without diabetes. In order to define the prognostic power of HbA1C among these patients, the cohort was divided into 3 groups according to HbA1C levels (<5.7, 5.7-6.4, >6.5). HR for HBA1C > 6.5 was 2.0334, p =0.041 (CI 95% 1.028-4.023) if compared with HBA1C









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