Outcomes of diabetic patients with end‐stage heart failure listed for heart transplantation: A propensity‐matched analysis

Akintoye, Emmanuel; Álvarez, Paulino; Salih, M. A. M.; Sellke, Frank W.; Briasoulis, Αlexandros

doi:10.1111/ctr.14590

Cited by 1 publication

(2 citation statements)

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“…Several epidemiological studies had previously indicated that recipients with T2D undergoing HT differ from other types of patients [ 7 ]. A recent study reported that patients with diabetes experienced poorer graft survival following transplantation (HR 1.17; 95% CI 1.08–1.26, P < 0.001), although the authors scored graft survival to further stratify the risk of patients with diabetes and found that graft survival was similar in low-risk diabetic patients and non-diabetic patients (HR 0.91; 95% CI 0.82–1.01) [ 23 ]. In our study, individuals with T2D were less likely to have pneumonia and Gram-negative bacterial infections or undergo hemodialysis, ECMO, and tracheostomy procedures.…”

Section: Discussionmentioning

confidence: 99%

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Temporal trends and outcomes of heart transplantation in Spain (2002–2021): propensity score matching analysis to compare patients with and without type 2 diabetes

Lopez-de-Andres,

Jiménez-García,

Hernández-Barrera

et al. 2023

Cardiovasc Diabetol

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Background The impact of Type 2 Diabetes (T2D) on the outcomes of heart transplantation (HT) has not yet been clearly established. The objectives of this study were to examine the trends in the prevalence of T2D among individuals who underwent a HT in Spain from 2002 to 2021, and to compare the clinical characteristics and hospitalization outcomes between HT recipients with and without T2D. Methods We used the national hospital discharge database to select HT recipients aged 35 and older. The International Classification of Diseases, Ninth and Tenth Revisions (ICD-9 and ICD-10) were used to identify patients with and without T2D. We also recorded comorbidities, complications of HT, and procedures. Propensity score matching (PSM) and Cox regression were used to analyze the effect of T2D on in-hospital mortality (IHM). Results Between 2002 and 2021, a total of 4429 HTs (T2D, 19.14%) were performed in Spain. The number of HTs in patients with T2D decreased from 2002 to 2005 (n = 171) to 2014–2017 (n = 154), then rose during 2018–2021 (n = 186). Complications of HT increased in patients with and without T2D over the study period (26.9% and 31.31% in 2002–2005 vs. 42.47% and 45.01% in 2018–2021, respectively). The results of the PSM showed that pneumonia and Gram-negative bacterial infections were less frequent in patients with T2D and that these patients less frequently required hemodialysis, extracorporeal membrane oxygenation (ECMO), and tracheostomy. They also had a shorter hospital stay and lower IHM than patients without diabetes. The variables associated with IHM in patients with T2D were hemodialysis and ECMO. IHM decreased over time in people with and without T2D. The Cox regression analysis showed that T2D was associated with lower IHM (HR 0.77; 95% CI 0.63–0.98). Conclusions The number of HTs increased in the period 2018–2021 compared with 2002–2005 in patients with and without T2D. Over time, complications of HT increased in both groups studied, whereas IHM decreased. The presence of T2D is associated with lower IHM.

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Section: Discussionmentioning

confidence: 99%

“…A love plot was generated to visualize how populations become comparable after PSM. PSM has been previously used by other authors to compare the outcomes of HT according to clinical conditions and procedures [23][24][25][26][27][28][29][30].…”

Section: Propensity Score Matchingmentioning

confidence: 99%