Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015)
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 f...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-017-0631-6 |
| _version_ | 1818930251980341248 |
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| author | Manuel Mendez-Bailon Noel Lorenzo-Villalba Nuria Muñoz-Rivas Jose Maria de Miguel-Yanes Javier De Miguel-Diez Josep Comín-Colet Valentin Hernandez-Barrera Rodrigo Jimenez-Garcia Ana Lopez-de-Andres |
| author_facet | Manuel Mendez-Bailon Noel Lorenzo-Villalba Nuria Muñoz-Rivas Jose Maria de Miguel-Yanes Javier De Miguel-Diez Josep Comín-Colet Valentin Hernandez-Barrera Rodrigo Jimenez-Garcia Ana Lopez-de-Andres |
| author_sort | Manuel Mendez-Bailon |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-20T03:57:44Z |
| format | Article |
| id | doaj.art-3dab78e206a74fc8a4cc94f35858872e |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-20T03:57:44Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-3dab78e206a74fc8a4cc94f35858872e2022-12-21T19:54:16ZengBMCCardiovascular Diabetology1475-28402017-11-011611810.1186/s12933-017-0631-6Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015)Manuel Mendez-Bailon0Noel Lorenzo-Villalba1Nuria Muñoz-Rivas2Jose Maria de Miguel-Yanes3Javier De Miguel-Diez4Josep Comín-Colet5Valentin Hernandez-Barrera6Rodrigo Jimenez-Garcia7Ana Lopez-de-Andres8Internal Medicine Department, Instituto de Investigación Cardiovascular, Hospital Clínico San Carlos, Complutense UniversityService de Médicine Interne et Cancerlogie, Centre Hospitalier Saint CyrInternal Medicine Department, Hospital Universitario Infanta LeonorInternal Medicine Department, Hospital General Universitario Gregorio MarañonPneumology Department, Hospital General Universitario Gregorio MarañonDepartment of Cardiology, Hospital Universitario de BellvitgePreventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos UniversityPreventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos UniversityPreventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos UniversityAbstract 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.http://link.springer.com/article/10.1186/s12933-017-0631-6Type 2 diabetesTranscatheter aortic valve implantationSurgical aortic valve replacementHospitalMortality |
| spellingShingle | Manuel Mendez-Bailon Noel Lorenzo-Villalba Nuria Muñoz-Rivas Jose Maria de Miguel-Yanes Javier De Miguel-Diez Josep Comín-Colet Valentin Hernandez-Barrera Rodrigo Jimenez-Garcia Ana Lopez-de-Andres Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) Cardiovascular Diabetology Type 2 diabetes Transcatheter aortic valve implantation Surgical aortic valve replacement Hospital Mortality |
| title | Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) |
| title_full | Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) |
| title_fullStr | Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) |
| title_full_unstemmed | Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) |
| title_short | Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014–2015) |
| title_sort | transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in spain 2014 2015 |
| topic | Type 2 diabetes Transcatheter aortic valve implantation Surgical aortic valve replacement Hospital Mortality |
| url | http://link.springer.com/article/10.1186/s12933-017-0631-6 |
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