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. 2022 Mar 18:9:844068.
doi: 10.3389/fcvm.2022.844068. eCollection 2022.

Trends and Outcomes of Aortic Valve Replacement in Patients With Diabetes in the US

Sarah Khan  1 , Soha Dargham  1 , Jassim Al Suwaidi  2 , Hani Jneid  3 , Charbel Abi Khalil  1   2   4
Affiliations

Trends and Outcomes of Aortic Valve Replacement in Patients With Diabetes in the US

Sarah Khan et al. Front Cardiovasc Med. .

Abstract

Aims: We aimed to assess the trend and outcome of aortic valve replacement in patients with diabetes.

Background: Diabetes is associated with higher cardiovascular events.

Methods: Data from the National Inpatient Sample was analyzed between 2012 and 2017. We compared hospitalizations and in-hospital cardiovascular outcomes in patients with diabetes to those without diabetes, hospitalized for aortic valve replacement.

Results: In diabetes patients undergoing TAVR, the mean age of participants decreased from 79.6 ± 8 to 67.8 ± 8, hospitalizations increased from 0.97 to 7.68/100,000 US adults (p < 0.002 for both). There was a significant temporal decrease in mortality, acute renal failure (ARF), and stroke. Compared to non-diabetic patients, those with diabetes had a higher risk of stroke, ARF, and pacemaker requirement [adjusted OR = 1.174 (1.03-1.34), 1.294 (1.24-1.35), 1.153 (1.11-1.20), respectively], but a similar adjusted mortality risk. In diabetes patients undergoing sAVR, the mean age of participants decreased from 70.4 ± 10 to 68 ± 9 (p < 0.001), hospitalizations dropped from 7.72 to 6.63/100,000 US adults (p = 0.025), so did mortality, bleeding, and ARF. When compared to non-diabetes patients, those with diabetes were older and had a higher adjusted risk of mortality, stroke, and ARF [adjusted OR= 1.115 (1.06-1.17), 1.140 (1.05-1.23), 1.217 (1.18-1.26); respectively].

Conclusion: The recent temporal trend of aortic valve replacement in patients with diabetes shows a significant increase in TAVR coupled with a decrease in sAVR. Mortality and other cardiovascular outcomes decreased in both techniques. sAVR, but not TAVR, was associated with higher in-hospital mortality risk.

Keywords: SAVR; TAVR; aortic stenosis; aortic valve repair; diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Temporal trend in hospitalization/100,000 US adults from 2012 to 2017 in (A) TAVR and (B) sAVR patients.
Figure 3
Figure 3
Temporal trend in mortality from 2012 to 2017 in (A) TAVR and (B) sAVR patients.
Figure 4
Figure 4
Temporal trend in total hospital charges from 2012 to 2017 in (A) TAVR and (B) sAVR patients.
See this image and copyright information in PMC

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