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. 2023 May 16;12(10):3502.
doi: 10.3390/jcm12103502.

Diabetes Mellitus in Patients Undergoing Mitral Transcatheter Edge-to-Edge Repair-A Decade Experience in 1000+ Patients

Michael Paukovitsch  1 , Dominik Felbel  1 , Matthias Groeger  1 , Wolfgang Rottbauer  1 , Sinisa Markovic  1 , Marijana Tadic  1 , Leonhard Moritz Schneider  1 , Mirjam Keßler  1
Affiliations

Diabetes Mellitus in Patients Undergoing Mitral Transcatheter Edge-to-Edge Repair-A Decade Experience in 1000+ Patients

Michael Paukovitsch et al. J Clin Med. .

Abstract

Background: Diabetes mellitus worsens outcomes in patients suffering from heart disease undergoing cardiac procedures.

Objectives: To investigate the impact of diabetes in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER).

Methods: 1118 patients treated with M-TEER for functional (FMR) and degenerative (DMR) mitral regurgitation (MR) between 2010 and 2021 were analyzed using the combined endpoint of death/rehospitalization for heart failure (HFH).

Results: Among diabetics (N = 306; 27.4%), comorbidities such as coronary artery disease (75.2% vs. 62.7%; p < 0.001) and progressed (stage III/IV) chronic kidney disease (79.5% vs. 72.6%; p = 0.018) were more frequent. The rate of FMR was higher in diabetics (71.9% vs. 64.5%; p < 0.001). The combined endpoint occurred more frequently in diabetics (40.2% vs. 35.6%; log-rank = 0.035). While no difference was observed in FMR patients (36.8% vs. 37.6%; log-rank p = 0.710), rates of the combined endpoint differed significantly between diabetics and non-diabetics in DMR patients (48.8% vs. 31.9%; log-rank p = 0.001) only. However, diabetes did neither predict the combined endpoint in the overall (OR: 0.97; 95% CI 0.65-1.45; p = 0.890) nor in the DMR cohort (OR: 0.73; 95% CI 0.35-1.51; p = 0.389). Among diabetics treated with M-TEER, troponin (OR: 2.32; 95% CI 1.3-3.7; p = 0.002) and estimated glomerular filtration rate (OR: 0.52; 95% CI 0.3-0.88; p = 0.018) independently predicted the combined endpoint.

Conclusions: Diabetes is associated with adverse outcomes after M-TEER, particularly in DMR patients. However, diabetes does not predict the combined endpoint. In diabetics undergoing M-TEER, biochemical markers associated with organ function and damage independently predict the combined endpoint of death and rehospitalization.

Keywords: diabetes; edge-to-edge repair; mitral valve.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Kaplan–Maier analysis of survival grouped according to non-diabetics and diabetics with functional mitral regurgitation (FMR). (b) Kaplan–Maier analysis of survival grouped according to non-diabetics and diabetics with degenerative mitral regurgitation (DMR).
See this image and copyright information in PMC

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