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Observational Study
. 2024 Jul 18;23(1):260.
doi: 10.1186/s12933-024-02356-2.

A high-volume study on the impact of diabetes mellitus on clinical outcomes after surgical and percutaneous cardiac interventions

S R Slingerland  1   2   3 , D N Schulz  4 , G J van Steenbergen  4 , M A Soliman-Hamad  4 , J M H Kisters  4 , M Timmermans  5 , K Teeuwen  4 , L Dekker  4   6 , D van Veghel  4   5 ; participating centres of the Cardiothoracic surgery registration committee, the PCI registration committee and the THI registration committee of the Netherlands Heart Registration (NHR)
Affiliations
Observational Study

A high-volume study on the impact of diabetes mellitus on clinical outcomes after surgical and percutaneous cardiac interventions

S R Slingerland et al. Cardiovasc Diabetol. .

Abstract

Background: Type I and type II diabetes mellitus (DM) patients have a higher prevalence of cardiovascular diseases, as well as a higher mortality risk of cardiovascular diseases and interventions. This study provides an update on the impact of DM on clinical outcomes, including mortality, complications and reinterventions, using data on percutaneous and surgical cardiac interventions in the Netherlands.

Methods: This is a retrospective, nearby nationwide study using real-world observational data registered by the Netherlands Heart Registration (NHR) between 2015 and 2020. Patients treated for combined or isolated coronary artery disease (CAD) and aortic valve disease (AVD) were studied. Bivariate analyses and multivariate logistic regression models were used to evaluate the association between DM and clinical outcomes both unadjusted and adjusted for baseline characteristics.

Results: 241,360 patients underwent the following interventions; percutaneous coronary intervention(N = 177,556), coronary artery bypass grafting(N = 39,069), transcatheter aortic valve implantation(N = 11,819), aortic valve replacement(N = 8,028) and combined CABG and AVR(N = 4,888). The incidence of DM type I and II was 21.1%, 26.7%, 17.8%, 27.6% and 27% respectively. For all procedures, there are statistically significant differences between patients living with and without diabetes, adjusted for baseline characteristics, at the expense of patients with diabetes for 30-days mortality after PCI (OR = 1.68; p <.001); 120-days mortality after CABG (OR = 1.35; p <.001), AVR (OR = 1.5; p <.03) and CABG + AVR (OR = 1.42; p =.02); and 1-year mortality after CABG (OR = 1.43; p <.001), TAVI (OR = 1.21; p =.01) and PCI (OR = 1.68; p <.001).

Conclusion: Patients with DM remain to have unfavourable outcomes compared to nondiabetic patients which calls for a critical reappraisal of existing care pathways aimed at diabetic patients within the cardiovascular field.

Keywords: Aortic valve replacement; Cardiovascular disease; Coronary artery bypass grafting; Endocrinology; Percutaneous coronary intervention; Transcatheter aortic valve implantation.

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Conflict of interest statement

The authors whose names are listed certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Cox regression curves per intervention of the study regarding survival and reinterventions. Blue lines; no diabetes mellitus, Red lines; diabetes mellitus
See this image and copyright information in PMC

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