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
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
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DOI：
10.1161/circinterventions.117.005417
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发表时间：
2017-11-01
影响因子：
5.6
通讯作者：
Makkar, Raj R.
中科院分区：
文献类型：
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作者：
Abramowitz, Yigal;Vemulapalli, Sreekanth;Makkar, Raj R.
背景糖尿病（DM）对心血管疾病和手术的发病率和死亡率有不利影响。评价糖尿病患者经导管主动脉瓣置换术（TAVR）结局的数据受到样本量小和结果矛盾的限制。我们的目的是建立风险的大小和胰岛素依赖的增量影响，通过检查短期和长期的不良后果，根据糖尿病的状态和治疗在世界上最大的TAVR registration.Methods和结果，我们分析了数据从社会胸外科医生/美国心脏病学院经导管瓣膜治疗注册。使用多变量建模评价了合并和不合并DM的患者TAVR术后的住院死亡率、30天死亡率和1年死亡率。2011年11月至2015年9月，在394家美国医院接受TAVR治疗的47643例患者中，有17849例（37.5%）患者患有DM。总体而言，6600名糖尿病患者接受胰岛素治疗（IT）。糖尿病患者30天死亡率为5.0%（IT型糖尿病为6.1%，非IT型糖尿病为4.4%; P
Background Diabetes mellitus (DM) adversely affects morbidity and mortality for cardiovascular diseases and procedures. Data evaluating the outcomes of transcatheter aortic valve replacement (TAVR) in diabetic patients are limited by small sample size and contradictory results. We aimed to establish the magnitude of risk and the incremental influence of insulin dependency by examining short- and long-term adverse outcomes according to DM status and therapy in the world's largest TAVR registry.Methods and Results We analyzed data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. In-hospital mortality, 30-day mortality, and 1-year mortality after TAVR in patients with and without DM were evaluated using multivariate modeling. Among 47 643 patients treated with TAVR from November 2011 through September 2015 at 394 US hospitals, there were 17 849 (37.5%) patients with DM. Overall, 6600 of the diabetic patients were insulin treated (IT). Thirty-day mortality was 5.0% in patients with DM (6.1% in IT DM and 4.4% in non-IT DM; P