Impact of glycemic control metrics on short- and long-term mortality in transcatheter aortic valve replacement patients: a retrospective cohort study from the MIMIC-IV database
Authors' conclusion
In critically ill TAVR patients, glycemic control metrics are closely associated with long-term all-cause mortality. The HGI, SHR, and GV provide prognostic insights into clinical outcomes that surpass conventional glucose measurements. These findings highlight the importance of personalized glycemic management strategies in improving TAVR patient outcomes.
Study context
- Population
- ICU-admitted transcatheter aortic valve replacement (TAVR) patients, MIMIC-IV database
- Participants
- 3,342 patients
- Exposure
- Tertiles of hemoglobin glycation index (HGI), stress hyperglycemia ratio (SHR) and glycemic variability (GV)
- Outcome
- All-cause mortality
- Follow-up
- 30-day and 365-day
Methodological detailsMIMIC-IV database, tertiles of HGI, SHR and GV, external validation
- MIMIC-IV database
- Tertiles of HGI, SHR and GV
- External validation
Main finding
As reported in the abstract
365-day all-cause mortality · 365 days
Hazard ratio (95% CI)P value
Lower HGIfully adjusted Cox model
1.48(1.05–2.09)
P = 0.025Higher SHRfully adjusted Cox model
1.63(1.15–2.32)
P = 0.006Lower GV
0.59(0.38–0.92)
P = 0.019Higher GV
1.43(1.06–1.93)
P = 0.020- 365-day mortality after TAVR
- 6.9%
Observational data: associations, not effects.
Further findings
30-day all-cause mortality
| HR (95% CI) | P value | ||
|---|---|---|---|
| Higher SHR | 2.92 (1.32–6.45) | P = 0.008 | |
| 0.10.31310Hazard ratio (log scale) |
- 30-day all-cause mortality — 30-day mortality after TAVR
- 1.6%
Original publication
Impact of glycemic control metrics on short- and long-term mortality in transcatheter aortic valve replacement patients: a retrospective cohort study from the MIMIC-IV database. Cardiovasc Diabetol. Published 22 March 2025. doi:10.
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