Improvement in Glycemic Control after Left Ventricular Assist Device Implantation in Advanced Heart Failure Patients with Diabetes Mellitus

Choudhary, Naila; Chen, Leway; Kotyra, Lisa; Wittlin, Steven D.; Alexis, Jeffrey D.

doi:10.1016/j.cardfail.2013.06.074

Cited by 2 publications

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“…In addition, as previously reported, LVAD therapy itself improves glycemic control, possibly because of decreased pancreatic congestion, normalization of biochemical derangements that result from depressed cardiac output, and improved circulation of insulin. [21][22][23][24] Finally, a multidisciplinary team approach to LVAD patients, including dietary consultation, might lead to improved glycemic control. 21 It is possible that such aggressive treatment resulted in a lack of significant differences in outcomes and survival between DM and non-DM groups.…”

Section: Discussionmentioning

confidence: 99%

Is Diabetes Mellitus a Risk Factor for Poor Outcomes after Left Ventricular Assist Device Placement?

Mohamedali

Yost

Bhat³

2017

Texas Heart Institute Journal

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Diabetes mellitus is associated with adverse outcomes in patients with cardiovascular diseases, including heart failure. Left ventricular assist devices (LVADs) are increasingly used as life-saving therapy for advanced heart failure. The effects of pre-LVAD diabetes on long-term outcomes after LVAD implantation are not well understood. In this study, we retrospectively evaluated the effect of existing diabetes on post-LVAD outcomes. Data on 288 LVAD recipients from 2006 through 2013 were reviewed. Patients were stratified in accordance with their histories of diabetes. Baseline demographic, laboratory, hemodynamic, and echocardiographic information before LVAD placement were reviewed, together with the post-LVAD incidence of major adverse outcomes. Kaplan-Meier analysis and Cox regression analysis were performed. Our cohort comprised 122 patients with diabetes and 166 patients without. The mean glycosylated hemoglobin A level in the diabetes group was 7.4% ± 1.6%. Diabetic patients at baseline had a more adverse medical profile than did nondiabetic patients. There were no differences in major outcomes between the 2 groups other than a higher incidence of hemolysis in the diabetes group: 12 (10%) vs 5 (3%); =0.02. There was no difference in survival outcomes between the groups. Diabetic patients did not have worse survival or more adverse outcomes than did nondiabetic patients in this study, perhaps because of improved diabetes control, or improvement in biochemical derangements after normalization of cardiac output with LVAD therapy. A diagnosis of diabetes was an independent predictor of hemolysis. Further studies to evaluate the link between hemolysis and diabetes are indicated.

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Section: Discussionmentioning

confidence: 99%

Is Diabetes Mellitus a Risk Factor for Poor Outcomes after Left Ventricular Assist Device Placement?

Mohamedali

Yost

Bhat³

2017

Texas Heart Institute Journal

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“…Some studies reported that LVAD implantation was associated with significant improvement in HbA1c, fasting plasma glucose and daily insulin need in DM patients with advanced HF (14,15). These results have some physio-pathologic explanations.…”

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confidence: 93%

Left ventricular assist device may improve glycemic control in diabetes mellitus patients but the reverse is not true

et al. 2018

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Improvement in Glycemic Control after Left Ventricular Assist Device Implantation in Advanced Heart Failure Patients with Diabetes Mellitus

Cited by 2 publications

References 0 publications

Is Diabetes Mellitus a Risk Factor for Poor Outcomes after Left Ventricular Assist Device Placement?

Is Diabetes Mellitus a Risk Factor for Poor Outcomes after Left Ventricular Assist Device Placement?

Left ventricular assist device may improve glycemic control in diabetes mellitus patients but the reverse is not true

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