Key result
Diabetes mellitus did not significantly increase 12-month all-cause mortality in patients undergoing TAVI compared to those without diabetes (OR 2.05; 95% CI 0.79-5.32; p=0.16).
Why the study?
Does diabetes mellitus worsen clinical outcomes and quality of life in patients undergoing TAVI for severe aortic stenosis?
Cohort (n=148)
Does diabetes mellitus worsen clinical outcomes and quality of life in patients undergoing TAVI for severe aortic stenosis?
Odds Ratio: 2.05 (95% CI 0.79–5.32)
Absolute Event Rate: 20.8% vs 12%
p-value: p=0.16
Diabetes mellitus does not appear to significantly worsen mortality, complication rates, or quality of life outcomes in patients undergoing TAVI for severe aortic stenosis.
Supports TAVI regardless of diabetes status for 12-month mortality; leaves open effects on complications, quality of life, and longer-term outcomes.
BACKGROUND: Diabetes mellitus (DM) is considered a marker of poor prognosis after cardiac surgery. We sought to investigate the effect 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, and the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM. RESULTS: DM was present in 48 of 148 (32.4%) patients. No differences in periprocedural risk (Logistic Euroscore and Society of Thoracic Surgeons (STS) scale) 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 the 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, complication rates, and QoL outcomes compared to patients without DM.
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Tokarek et al. (2017) conducted a cohort in Symptomatic, severe aortic stenosis (n=148). Diabetes mellitus vs. No diabetes mellitus was evaluated on 12-month all-cause mortality (OR 2.05, 95% CI 0.79-5.32, p=0.16). Diabetes mellitus did not significantly increase 12-month all-cause mortality in patients undergoing TAVI compared to those without diabetes (OR 2.05; 95% CI 0.79-5.32; p=0.16).
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