Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/124232
Title: Transcatheter Aortic Valve Implantation And Surgical Aortic Valve Replacement Among Hospitalized Patients With And Without Type 2 Diabetes Mellitus In Spain (2014-2015)
Author: Mendez Bailon, Manuel
Lorenzo Villalba, Noel
Muñoz Rivas, Nuria
Miguel Yanes, Jose Maria de
Miguel Diez, Javier de
Comín Colet, Josep
Hernández Barrera, Valentín
Jiménez García, Rodrigo
Lopez de Andrés, Ana
Keywords: Diabetis no-insulinodependent
Mortalitat
Malalties cardiovasculars
Non-insulin-dependent diabetes
Mortality
Cardiovascular diseases
Issue Date: 9-Nov-2017
Publisher: BioMed Central
Abstract: Background: Type 2 diabetes mellitus (T2DM) is strongly related to the in-hospital and short-term prognosis in patients with cardiovascular diseases needing surgical or invasive interventions. How T2DM might influence the treatment of aortic stenosis (AS) has not been completely elucidated for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). The aims of this study were: (1) to describe the use of aortic valve replacement procedures (TAVI and SAVR) among hospitalized patients with and without T2DM; and (2) to identify factors associated with in hospital mortality (IHM) among patients undergoing these procedures. Methods: We analyzed data from the Spanish National Hospital Discharge Database between January 1, 2014 and December 31, 2015 for patients aged >= 40 years. We selected patients whose medical procedures included TAVI (ICD-9-CM codes 35.05, 35.06) and SAVR (ICD-9-CM codes 35.21, 35.22). We stratified each cohort by diabetes status: T2DM (ICD-9-CM codes 250.x0, 250.x2) and no diabetes. We retrieved data about specific comorbidities, risk factors, procedures, and specific in-hospital postoperative complications. Hospital outcome variables included IHM, and length of hospital stay (LOHS). Results: We identified a total of 2141 and 16,013 patients who underwent TAVI (n = 715; 33.39% with T2DM) and SAVR (n = 4057; 25.33% with T2DM). In patients who underwent TAVI we found no differences in IHM (3.64% in T2DM vs. 5.12% in non-T2DM, p = 0.603). In the cohort of SAVR, mean LOHS was significantly lower in patients with T2DM than in non-diabetic patients (13.77 vs. 17.27 days). IHM was lower in patients with T2DM (4.36% vs. 6.31%, p < 0.01). After multivariable adjustment for both procedures, patients with T2DM had significantly lower IHM than patients without diabetes (adjusted OR 0.60; IC 95% 0.37-0.99 for TAVI and adjusted OR 0.80; IC 95% 0.66-0-96 for SAVR). Conclusions: T2DM diabetic patients with AS undergoing a valvular replacement procedure through SAVR or TAVI did not have a worse prognosis compared to non-diabetic patients during hospitalization, showing lower IHM after multivariable adjustment. However, given the limitations of administrative data more prospective studies and clinical trials aimed at evaluating the influence of these procedures in diabetic patients with AS are needed.
Note: Reproducció del document publicat a: https://doi.org/10.1186/s12933-017-0631-6
It is part of: Cardiovascular Diabetology, 2017, vol. 16, num. 144
URI: http://hdl.handle.net/2445/124232
Related resource: https://doi.org/10.1186/s12933-017-0631-6
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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