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Diabetes Effect on TAVR Procedures Outcome

According to this article diabetes mellitus (DM) significantly affects mortality and morbidity for cardiovascular procedures and ailments.

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According to this article diabetes mellitus (DM) significantly affects mortality and morbidity for cardiovascular procedures and ailments. The authors analysed data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Registry. With the help of multivariate modelling, in-hospital mortality, 1-year mortality, and 30-day mortality upon TAVR in patients that had or did not have diabetes mellitus. The results showed that diabetes mellitus did portend increased long-term risk at TAVR, but did not confer an increased short-term risk upon this procedure.

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Abramowitz, Y., Vemulapalli, S., Chakravarty, T., Li, Z., Kapadia, S., Holmes, D., ... & Makkar, R. R. (2017). Clinical impact of diabetes mellitus on outcomes after transcatheter aortic valve replacement: insights from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Circulation: Cardiovascular Interventions, 10(11), e005417. https://doi.org/10.1161/CIRCINTERVENTIONS.117.005417

 

This article sought to look at the impacts of diabetes mellitus on quality of life and clinical outcomes upon the transcatheter aortic valve implantation (TAVI). The researchers included 148 consecutive patients who had severe and symptomatic cases of aortic stenosis that had done the TAVI procedure. Baseline traits and procedural long-term clinical results, as well as quality of life analysis were done with the aid of EQ-5D-3L questionnaire were compared among respondent patients with and without diabetes mellitus. The results of this study pointed to there being no difference between patients that had diabetes mellitus undergoing TAVI and those without diabetes mellitus. They both showed similar complication rates, quality of life, and mortality.

 

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Tokarek, T., Dziewierz, A., Wiktorowicz, A., Bagienski, M., Rzeszutko, L., Sorysz, D., & Dudek, D. (2018). Effect of diabetes mellitus on clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic valve stenosis. Hellenic Journal of Cardiology, 59(2), 100-107. https://doi.org/10.1016/j.hjc.2017.08.002

 

In this study, the researchers sought to investigate diabetes mellitus’ impact on short-term clinical results upon TAVR procedure within a large randomized trial populace. This research utilized BRAVO-3 trial randomized 802 respondent patients subjected to trans-famoral TAVR to unfractionated heparin- or bivalirudin-mediated procedural anticoagulation. The study respondents were categorized with respect to diabetes mellitus presence, and then stratified according to diabetes mellitus, then consequently categorized according to insulin use. The results concluded that respondents with DM had significantly higher chances of bleeding and vascular implications up to 30 days after TAVR procedure. Overall, there was no particular link between diabetes mellitus and early mortality post-TAVR.

 

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Mina, G. S., Gill, P., Soliman, D., Reddy, P., & Dominic, P. (2017). Diabetes mellitus is associated with increased acute kidney injury and 1‐year mortality after transcatheter aortic valve replacement: A meta‐analysis. Clinical cardiology, 40(9), 726-731. https://doi.org/10.1002/clc.22723

 

This meta-analysis sought to find the link between DM and TAVR procedures. The researchers sourced for articles that evaluated post-TAVR outcomes from Cochrane Central Register of Controlled Trials and PubMed. They then stratified at least one of the studied end results by DM status. The main end-point was all-cause death after 1 year. Secondary endpoints were up to 1-month deaths, cerebrovascular accident (CVA), and acute kidney injury (AKI). In the end, the researchers settled on 64 results with 38 686 respondent patients. Overall, the results indicated an association between DM and elevated periprocedural AKI and 1-year mortality in patients undergoing TAVR. Hence, the conclusion that DM is a precursor of adverse outcomes in patients subjected to TAVR.

 

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Goel, R., Power, D., Tchetche, D., Chandiramani, R., Guedeney, P., Claessen, B. E., & Dangas, G. D. (2019). Impact of diabetes mellitus on short term vascular complications after TAVR: Results from the BRAVO-3 randomized trial. International journal of cardiology, 297, 22-29. https://doi.org/10.1016/j.ijcard.2019.09.063

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