Trends and Outcomes of Aortic Valve Replacement in Patients With Diabetes in the US

Frontiers in Cardiovascular Medicine

article

Sarah Khan¹  Soha Dargham¹  Jassim Al Suwaidi²  Hani Jneid³  Charbel Abi Khalil¹ 

[1] Research Department, Weill Cornell Medicine-Qatar;Heart Hospital;The Michael E. DeBakey VA Medical Centre, Baylor College of Medicine;Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine

关键词: aortic stenosis;    aortic valve repair;    SAVR;    TAVR;    diabetes;   

DOI  :  10.3389/fcvm.2022.844068

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Aims We aimed to assess the trend and outcome of aortic valve replacement in patients with diabetes. Background Diabetes is associated with higher cardiovascular events. Methods Data from the National Inpatient Sample was analyzed between 2012 and 2017. We compared hospitalizations and in-hospital cardiovascular outcomes in patients with diabetes to those without diabetes, hospitalized for aortic valve replacement. Results In diabetes patients undergoing TAVR, the mean age of participants decreased from 79.6 ± 8 to 67.8 ± 8, hospitalizations increased from 0.97 to 7.68/100,000 US adults ( p < 0.002 for both). There was a significant temporal decrease in mortality, acute renal failure (ARF), and stroke. Compared to non-diabetic patients, those with diabetes had a higher risk of stroke, ARF, and pacemaker requirement [adjusted OR = 1.174 (1.03–1.34), 1.294 (1.24–1.35), 1.153 (1.11–1.20), respectively], but a similar adjusted mortality risk. In diabetes patients undergoing sAVR, the mean age of participants decreased from 70.4 ± 10 to 68 ± 9 ( p < 0.001), hospitalizations dropped from 7.72 to 6.63/100,000 US adults ( p = 0.025), so did mortality, bleeding, and ARF. When compared to non-diabetes patients, those with diabetes were older and had a higher adjusted risk of mortality, stroke, and ARF [adjusted OR= 1.115 (1.06–1.17), 1.140 (1.05–1.23), 1.217 (1.18–1.26); respectively]. Conclusion The recent temporal trend of aortic valve replacement in patients with diabetes shows a significant increase in TAVR coupled with a decrease in sAVR. Mortality and other cardiovascular outcomes decreased in both techniques. sAVR, but not TAVR, was associated with higher in-hospital mortality risk.

【 授权许可】

CC BY