Outcomes for Patients With Diabetes After Continuous-Flow Left Ventricular Assist Device Implantation

Left ventricular assist device implantation improves glycaemic control: a systematic review and meta‐analysis

“…While Vest et al 17 did not see a significant association between diabetes and all-cause mortality in 300 mostly bridge-to-transplant LVAD patients (P = 0.58), a recently published study by Asleh et al 16 suggested a nearly two-fold higher mortality risk in 341 diabetics. Disagreement exists regarding the diabetes is associated with worsened clinical outcomes in LVAD patients.…”

“…Disagreement exists regarding the diabetes is associated with worsened clinical outcomes in LVAD patients. While Vest et al 17 did not see a significant association between diabetes and all-cause mortality in 300 mostly bridge-to-transplant LVAD patients (P = 0.58), a recently published study by Asleh et al 16 suggested a nearly two-fold higher mortality risk in 341 diabetics. Interestingly, Asleh et al saw no association between preoperative HbA1c values and post-LVAD outcomes.…”

“…(Table 1). 6,[16][17][18][19][20][21][22][23][24][25][26][27] All studies were single-centre, retrospective observational investigations that utilized a pre-post design and were published as full-text articles, except one that is only available in abstract form. 16 Sample sizes ranged from 11 to 139 with durations of follow-up ranging from 126 days to 12 months.…”

“…Pooled analysis showed a significant 24.4 mg/dL reduction at followup (95% CI À33.4 to À15.5) and little statistical heterogeneity (I 2 = 7%, Cochrane P = 0.37) ( Figure 3). Eight studies 6,[16][17][18][21][22][23][24] reported insulin requirements, showing patients required 18.8 (95% CI À28.8 to À8.7; I 2 = 66%, Cochrane P < 0.01) fewer units of insulin per day following LVAD implantation ( Figure 4). Changes in BMI (kilogram per square metre) were reported in seven studies, 6,16-18,21-23 which revealed no significant difference after LVAD implantation (MD 0.09, 95% CI À1.24 to 1.42; I 2 = 43%, Cochrane P = 0.11) ( Figure 5).…”

“…However, significant reductions in post-LVAD serum creatinine (milligrams per decilitre) levels were seen in a pooled analysis of seven studies (MD À0.20, 95% CI À0.35 to À0.06; I 2 = 25%, Cochrane P = 0.24) (Figure 6) 6,17,22,23,[25][26][27]. Changes in BMI (kilogram per square metre) were reported in seven studies, 6,16-18,21-23 which revealed no significant difference after LVAD implantation (MD 0.09, 95% CI À1.24 to 1.42; I 2 = 43%, Cochrane P = 0.11) (Figure 5).…”