Key result
Diabetes mellitus has an unclear impact on mortality and major adverse outcomes after left ventricular assist device implantation, with no consensus in the current literature.
Why the study?
Comorbid diabetes mellitus complicates left ventricular assist device treatment outcomes, but there is no literature consensus regarding mortality or major adverse outcomes in these patients.
Does diabetes mellitus impact mortality and major adverse outcomes in patients with advanced heart failure undergoing left ventricular assist device therapy?
Does diabetes mellitus impact mortality and major adverse outcomes in patients with advanced heart failure undergoing left ventricular assist device therapy?
This review highlights that while LVAD implantation may lower HbA1c in patients with diabetes, current literature lacks consensus on whether diabetes significantly worsens mortality or adverse outcomes post-implantation.
Unclear diabetes impact on post-LVAD outcomes supports individualized risk assessment; leaves open need for prospective studies to resolve inconsistencies.
Heart failure (HF) represents a significant health burden in the United States, resulting in substantial mortality and healthcare costs. Through the array of treatment options available, including lifestyle modifications, medications, and implantable devices, HF management has evolved. Left ventricular assist devices (LVADs) have emerged as a crucial intervention, particularly in patients with advanced HF. However, the prevalence of comorbidities such as diabetes mellitus (DM) complicates treatment outcomes. By elucidating the impact of DM on LVAD outcomes, this review aims to inform clinical practice and enhance patient care strategies for individuals undergoing LVAD therapy. Patients with DM have higher rates of hypertension, dyslipidemia, peripheral vascular disease, and renal dysfunction, posing challenges to LVAD management. The macro/microvascular changes that occur in DM can lead to cardiomyopathy and HF. Glycemic control post LVAD implantation is a critical factor affecting patient outcomes. The recent literature has shown significant decreases in hemoglobin A1c following LVAD implantation, representing a possible bidirectional relationship between DM and LVADs; however, the clinical significance of this decrease is unclear. Furthermore, while some studies show increased short- and long-term mortality in patients with DM after LVAD implantation, there still is no literature consensus regarding either mortality or major adverse outcomes in DM patients.
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Crugnola et al. (2024) conducted a review in Heart failure. Diabetes Mellitus was evaluated on Mortality or major adverse outcomes. Diabetes mellitus has an unclear impact on mortality and major adverse outcomes after left ventricular assist device implantation, with no consensus in the current literature.
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