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

Slingerland, SR; Schulz, DN; van Steenbergen, GJ; Soliman-Hamad, MA; Kisters, JMH; Timmermans, M; Teeuwen, K; Dekker, L; van Veghel, D; participating centres of the Cardiothoracic surgery registration committee, the PCI registration committee and the THI registration committee of the Netherlands Heart Registration (NHR)

doi:10.1186/s12933-024-02356-2

Type 2 & other diabetes

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

Cardiovasc DiabetolPublished 18 Jul 2024Retrospective cohort study

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Authors' 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.

Study context

Population: Patients treated for combined or isolated coronary artery disease and aortic valve disease with PCI, CABG, TAVI, AVR or combined CABG and AVR, Netherlands, 2015–2020aortic valve disease with PCI 177,556 · CABG 39,069 · TAVI 11,819 · AVR 8,028 · AVR 4,888
Participants: 241,360 patients

Exposure: Patients with diabetes mellitus (DM) vs without DM
Outcome: Clinical outcomes, including mortality, complications and reinterventions

Methodological detailsnearby nationwide, real-world observational data, Netherlands Heart Registration 2015–2020, multivariate logistic regression adjusted for baseline characteristics

Nearby nationwide
Real-world observational data
Netherlands Heart Registration 2015–2020
Multivariate logistic regression adjusted for baseline characteristics

Main finding

As reported in the abstract

Mortality, patients with vs without diabetes, by procedure

30-day mortality after PCI, OR (with vs without diabetes): OR = 1.68; p <.001
120-day mortality after CABG, OR (with vs without diabetes): OR = 1.35; p <.001
120-day mortality after AVR, OR (with vs without diabetes): OR = 1.5; p <.03
120-day mortality after CABG + AVR, OR (with vs without diabetes): OR = 1.42; p =.02
1-year mortality after CABG, OR (with vs without diabetes): OR = 1.43; p <.001
1-year mortality after TAVI, OR (with vs without diabetes): OR = 1.21; p =.01
1-year mortality after PCI, OR (with vs without diabetes): OR = 1.68; p <.001

Observational data: associations, not effects.

Further findings

Incidence of DM type I and II by procedure (PCI, CABG, TAVI, AVR, CABG + AVR)

PCI: 21.1%
CABG: 26.7%
TAVI: 17.8%
AVR: 27.6%
CABG + AVR: 27%

Reference

Authors: Slingerland SR, Schulz DN, van Steenbergen GJ, Soliman-Hamad MA, Kisters JMH, Timmermans M, et al.
All 10 authors
Slingerland SR, Schulz DN, van Steenbergen GJ, Soliman-Hamad MA, Kisters JMH, Timmermans M, Teeuwen K, Dekker L, van Veghel D, participating centres of the Cardiothoracic surgery registration committee, the PCI registration committee and the THI registration committee of the Netherlands Heart Registration (NHR)
Journal: Cardiovascular Diabetology
Published: 18 Jul 2024
DOI: 10.1186/s12933-024-02356-2
PubMed: 39026315

Topic: Type 2 & other diabetes
Also indexed: Type 1 diabetes

Exposure definitions

DM: type I and type II diabetes mellitus
No DM: patients without diabetes

Key notes

Adjusted for baseline characteristics
Significant differences at the expense of patients with diabetes

Original publication

A high-volume study on the impact of diabetes mellitus on clinical outcomes after surgical and percutaneous cardiac interventions. Cardiovasc Diabetol. Published 18 July 2024. doi:10.1186/s12933-024-02356-2

Read the original article ↗

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