BACKGROUND: Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR). HYPOTHESIS: DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR. METHODS: We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accident (CVA), major bleeding, and major vascular complications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models. RESULTS: We included 64 studies with a total of 38 686 patients. DM was associated with significantly higher 1-year mortality (OR: 1.14, 95% CI: 1.04-1.26, P = 0.008) and periprocedural AKI (OR: 1.28, 95% CI: 1.08-1.52, P = 0.004). On the other hand, there were no significant differences between diabetics and nondiabetics in early mortality, CVAs, major bleeding, or major vascular complications. CONCLUSIONS: DM is associated with increased 1-year mortality and periprocedural AKI in patients undergoing TAVR. The results of this study suggest that DM is a predictor of adverse outcomes in patients undergoing TAVR.
BACKGROUND:Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR). HYPOTHESIS: DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR. METHODS: We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accident (CVA), major bleeding, and major vascular complications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models. RESULTS: We included 64 studies with a total of 38 686 patients. DM was associated with significantly higher 1-year mortality (OR: 1.14, 95% CI: 1.04-1.26, P = 0.008) and periprocedural AKI (OR: 1.28, 95% CI: 1.08-1.52, P = 0.004). On the other hand, there were no significant differences between diabetics and nondiabetics in early mortality, CVAs, major bleeding, or major vascular complications. CONCLUSIONS:DM is associated with increased 1-year mortality and periprocedural AKI in patients undergoing TAVR. The results of this study suggest that DM is a predictor of adverse outcomes in patients undergoing TAVR.
Authors: Matthew A Cavender; Ph Gabriel Steg; Sidney C Smith; Kim Eagle; E Magnus Ohman; Shinya Goto; Julia Kuder; Kyungah Im; Peter W F Wilson; Deepak L Bhatt Journal: Circulation Date: 2015-07-07 Impact factor: 29.690
Authors: Raj R Makkar; Gregory P Fontana; Hasan Jilaihawi; Samir Kapadia; Augusto D Pichard; Pamela S Douglas; Vinod H Thourani; Vasilis C Babaliaros; John G Webb; Howard C Herrmann; Joseph E Bavaria; Susheel Kodali; David L Brown; Bruce Bowers; Todd M Dewey; Lars G Svensson; Murat Tuzcu; Jeffrey W Moses; Matthew R Williams; Robert J Siegel; Jodi J Akin; William N Anderson; Stuart Pocock; Craig R Smith; Martin B Leon Journal: N Engl J Med Date: 2012-03-26 Impact factor: 91.245
Authors: David H Adams; Jeffrey J Popma; Michael J Reardon; Steven J Yakubov; Joseph S Coselli; G Michael Deeb; Thomas G Gleason; Maurice Buchbinder; James Hermiller; Neal S Kleiman; Stan Chetcuti; John Heiser; William Merhi; George Zorn; Peter Tadros; Newell Robinson; George Petrossian; G Chad Hughes; J Kevin Harrison; John Conte; Brijeshwar Maini; Mubashir Mumtaz; Sharla Chenoweth; Jae K Oh Journal: N Engl J Med Date: 2014-03-29 Impact factor: 91.245
Authors: Michael E Halkos; Patrick Kilgo; Omar M Lattouf; John D Puskas; William A Cooper; Robert A Guyton; Vinod H Thourani Journal: Ann Thorac Surg Date: 2010-07 Impact factor: 4.330
Authors: James B Hermiller; Steven J Yakubov; Michael J Reardon; G Michael Deeb; David H Adams; Jonathan Afilalo; Jian Huang; Jeffrey J Popma Journal: J Am Coll Cardiol Date: 2016-07-26 Impact factor: 24.094
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: PLoS Med Date: 2009-07-21 Impact factor: 11.069