Key result
In patients undergoing transcatheter edge-to-edge mitral valve repair, the presence of diabetes mellitus did not significantly impact one-year all-cause mortality (24.2% vs 23.0%, p=0.72) compared to those without diabetes.
Why the study?
Data on patients with diabetes undergoing transcatheter edge-to-edge repair (TEER) in real-world settings were limited, and previous data indicated they had a worse prognosis.
Does transcatheter edge-to-edge mitral valve repair have similar safety and efficacy in patients with severe mitral regurgitation and diabetes compared to those without diabetes?
Cohort (n=340)
No
Does transcatheter edge-to-edge mitral valve repair have similar safety and efficacy in patients with severe mitral regurgitation and diabetes compared to those without diabetes?
Absolute Event Rate: 24.2% vs 23%
p-value: p=0.72
In a real-world cohort, transcatheter edge-to-edge mitral valve repair was similarly safe and effective at one year in patients with and without diabetes, despite diabetic patients having more comorbidities.
Supports TEER use in diabetics with severe MR; extends limited real-world data but leaves open independent prognostic impact.
BACKGROUND: There are only limited data on patients with diabetes undergoing transcatheter edge-to-edge repair (TEER) in real-world settings. Previous data indicated patients with diabetes to have a worse prognosis. This study sought to evaluate safety and efficacy of TEER in patients with diabetes in a real-world cohort. METHODS: In this monocentric study 340 consecutive patients with severe primary and secondary mitral regurgitation (MR) undergoing TEER were included. Immediate results of the procedure, intrahospital and one-year outcome were compared between patients with and without diabetes. RESULTS: Diabetes was present in 109 patients (32%). Patients with diabetes were younger (77 y (71, 81) vs. 79 y (74, 83); p = 0.003), had more often ischemic cardiomyopathy (68% vs. 48%; p<0.001), previous coronary-artery bypass graft (35% vs. 20%; p = 0.002) and arterial hypertension (89% vs. 75%; p<0.001) compared to those without diabetes. Baseline NYHA class, type of MR (primary vs. secondary), left ventricular dimensions and function (ejection fraction: 37% (28, 50) vs. 40% (29, 55); p = 0.10) as well as severity of MR were not different between both groups. Success of the procedure (95% vs. 95%; p = 0.84), intrahospital mortality (5.5% vs. 4.8%; p = 0.98) and one-year follow-up regarding all-cause mortality (24.2% vs. 23.0%; p = 0.72), hospitalization for heart failure (37.4% vs. 31.0%, p = 0.23), NYHA class (p = 0.14) or MR severity (p = 0.59) did not differ between both groups. CONCLUSION: Our real-world data suggest that TEER seems to be similarly safe and effective in patients with severe MR and diabetes compared to those without diabetes.
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Kirschfink et al. (2022) conducted a cohort in Severe primary and secondary mitral regurgitation (n=340). Diabetes mellitus vs. No diabetes mellitus was evaluated on One-year all-cause mortality (p=0.72). In patients undergoing transcatheter edge-to-edge mitral valve repair, the presence of diabetes mellitus did not significantly impact one-year all-cause mortality (24.2% vs 23.0%, p=0.72) compared to those without diabetes.
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