Effect of diabetes mellitus on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic valve stenosis

Tokarek, Tomasz; Dziewierz, Artur; Wiktorowicz, Agata; Bagieński, Maciej; Rzeszutko, Łukasz; Sorysz, Danuta; Kleczyński, Paweł; Dudek, Dariusz

doi:10.1016/j.hjc.2017.08.002

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…On the other hand, several studies have shown similar outcomes in 30-day and follow-up mortality among diabetic and nondiabetic patients, even when subdivided according to the type of DM treatment. 5,12 In our study, we found an increase in medium-term mortality for all causes in the subgroup of patients with insulin-dependent diabetes mellitus, and not in patients with non-insulin-dependent diabetes mellitus. This is in agreement with the findings of the studies of Conrotto et al 11 and Abramowitz et al, 6 which demonstrated a similar association.…”

Section: Discussioncontrasting

confidence: 38%

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Assessment of the impact of diabetes mellitus on clinical outcomes after transcatheter aortic valve implantation

Dutra¹,

Mangione²,

Mauro³

et al. 2019

J Transcat Intervent

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Section: Discussioncontrasting

confidence: 38%

“…4 However, evidence of the influence of diabetes on outcomes of patients undergoing TAVI is scarce and contradictory. [5][6][7][8] The objective of this study was to investigate the impact of diabetes on clinical outcomes in the short and medium term in patients with severe aortic stenosis undergoing TAVI.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the impact of diabetes mellitus on clinical outcomes after transcatheter aortic valve implantation

Dutra¹,

Mangione²,

Mauro³

et al. 2019

J Transcat Intervent

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“…Importantly, this was not reflected in higher mortality rate in DM patients undergoing TAVI. In study by Tokarek et al, 110 DM was not associated with a higher 30-day or 12-month all-cause mortality after TAVI nor was it associated with decreased post-procedural quality of life. A study by Mendez-Bailon et al 111 as well as a meta-analysis by Sun et al 112 did not find that diabetic patients have worse short-term outcome compared to non-diabetic patients when it comes to TAVI versus SAVR, or to TAVI only.…”

Section: Interventional Therapymentioning

confidence: 83%

Aortic stenosis and diabetes mellitus: An ominous combination

Banović

Athithan

McCann

2019

Diabetes and Vascular Disease Research

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Aortic stenosis and diabetes mellitus are both progressive diseases which, if left untreated, result in significant morbidity and mortality. There is evidence that the prevalence of diabetes is substantially increased in patients with aortic stenosis and those with diabetes have increased rates of progression from mild to severe aortic stenosis. There are good data supporting the hypothesis that aortic stenosis and diabetes mellitus are associated with diabetes mellitus being detrimental towards the quality of life and survival of patients. Thus, a thorough understanding of the pathogenesis of both of these disease processes and the relationship between them aids in designing appropriate preventive and therapeutic approaches. This review aims to give a comprehensive and up-to-date insight into the influence of diabetes mellitus on patients with degenerative aortic stenosis, as well as the prognosis and therapeutic approach to these patients.

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“…The obese patients had a higher prevalence of comorbidities, including diabetes mellitus [6]. A link between major vascular and bleeding complications and insulin-treated diabetes was reported [24,25]. Improved operator skills and a reduction in sheath and valve sizes may be partially responsible for the decreased rate of vascular complications as compared to previous studies.…”

Section: Discussionmentioning

confidence: 96%

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

Tokarek¹,

Dziewierz²,

Sorysz³

et al. 2019

Kardiol Pol

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A b s t r a c tBackground: Conflicting results have been presented regarding the influence of body mass index (BMI) on outcomes among patients undergoing transcatheter aortic valve implantation (TAVI). Aims:To investigate the impact of BMI on clinical outcomes after TAVI.Methods: A total of 148 consecutive patients were categorised using baseline BMI according to the World Health Organization criteria. Baseline patient characteristics, frailty, and procedural and clinical outcomes including 30-day and 12-month all-cause mortality were compared between the BMI categories. Patients were followed up for a median of 460.0 (182.0-1042.0) days. Results:Obesity was diagnosed in 37 (25.2%) patients, 73 (49.7%) patients were overweight, and 37 (25.2%) had normal weight. Prevalence of lower frailty as assessed by five-metre walk test was confirmed in obese patients as compared to other groups. A trend towards a lower rate of in-hospital bleeding complications (18 [48.6%] vs. 21 [28.8%] vs. 9 [24.3%] in normal-weight, overweight, and obese patients, respectively; p = 0.06) and less frequent blood transfusions (18 [48.6%] vs. 17 [23.3%) vs. 8 [21.6%]; p = 0.016) was observed in overweight and obese groups. The rate of grade 3 acute kidney injury was lowest in the overweight group (4 [10.8%] vs. 1 [1.4%] vs. 3 [8.1%]; p = 0.05). There was no difference between the groups in terms of 30-day all-cause mortality (p = 0.15). However, 12-month all-cause mortality was lowest in obese patients (12 [32.4%] vs. 10 [13.7%] vs. 2 [5.4%]; p = 0.004). Increase in BMI was independently associated with lower all-cause mortality (hazard ratio [95% confidence interval] per 1 kg/m 2 increase: 0.91 [0.845-0.98]; p = 0.018). Conclusions:Increased BMI was independently associated with survival benefit after TAVI.

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Effect of diabetes mellitus on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic valve stenosis

Abstract: Patients with DM undergoing TAVI demonstrated similar mortality, complication rates, and QoL outcomes compared to patients without DM.

Cited by 18 publications

References 28 publications

Assessment of the impact of diabetes mellitus on clinical outcomes after transcatheter aortic valve implantation

Assessment of the impact of diabetes mellitus on clinical outcomes after transcatheter aortic valve implantation

Aortic stenosis and diabetes mellitus: An ominous combination

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

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