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Dtsch Med Wochenschr. 2014 Apr;139(16):822-8. doi: 10.1055/s-0034-1369863. Epub 2014 Apr 10.

[Diabetes increases short- and long-term mortality after transcatheter aortic valve implantation (TAVI)].

[Article in German]

Author information

1
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
2
Abteilung Medizinische Statistik, Universitätsmedizin Göttingen.
3
Klinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsmedizin Göttingen.

Abstract

BACKGROUND AND AIM:

Long-term mortality after transcatheter aortic valve implantation (TAVI) in elderly patients with abundant comorbidities is considerable. We aimed to determine the impact of diabetes on short- and long-term mortality after TAVI.

METHODS:

Our study includes 300 consecutive patients (mean age, 82 ± 5 years) who underwent TAVI (158 transapical, 142 transfemoral procedures). All patients were followed by regular telephone contacts. 36% suffered from diabetes.

RESULTS:

Diabetes could be identified as significant predictor of short- and long-term mortality after TAVI. In diabetic patients, 30-day-mortality was 2,5 fold elevated (18.3% vs. 7.3%, p = 0.004). Furthermore, they were at significantly higher risk of peri-interventional stroke (p = 0.04), stage 3 acute kidney injury (p = 0.003), and prolonged ventilation (p = 0.01). Even after successful TAVI and discharge from hospital, long-term mortality was significantly elevated in diabetic patients (56% vs. 30%, p < 0.0001). Of note, 25% of diabetic vs. only 8% of non-diabetic patients died from cardiac causes during follow-up, suggesting that TAVI is not able to reduce cardiac-related mortality risk in diabetic patients to the same extent as in non-diabetics.

CONCLUSION:

Diabetes represents a powerful predictor of adverse early and late outcome after TAVI. These findings should be incorporated into the assessment of the risk-to-benefit ratio of TAVI in diabetic patients.

PMID:
24722931
DOI:
10.1055/s-0034-1369863
[Indexed for MEDLINE]
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