Diabetes and outcomes after left ventricular assist device placement.
BACKGROUND
Patients with diabetes have poorer outcomes after surgery in general. In this study, we assess the impact of diabetes on outcomes after left ventricular assist devices (LVAD) placement.


RESULTS
Data on 222 patients (57 diabetics) who underwent Novacor LVAD placement between 1996 and 2003 were compared for outcomes among patients who did and did not have diabetes. Significant differences between the diabetics versus nondiabetics included age (56 +/- 8 versus 49 +/- 1 years, P < .01), ischemic heart failure etiology (61% versus 44%, P = .04), history of hypertension (56% versus 30%, P < .01), thoracotomy (42% versus 30%, P = .08), stroke (14% versus 5%, P = .03), and body weight (86 +/- 16 kg versus 80 +/- 17 kg, P = .03), respectively. Eighty-four patients died on LVAD support, 28 of whom were diabetic. Thirty, 180, and 365-day survival for diabetic versus nondiabetic patients was: 76.6%, 45.6%, and 30.4% for diabetics and 86.7%, 62.4%, and 47.1% for nondiabetics (P = .02 for 180 and 365-day morality). After controlling for other variables, patients with diabetes were at a higher risk of mortality (OR 1.76, 95%CI 1.05-2.94). No significant difference in survival was noted between insulin-dependent versus non-insulin-dependent diabetics.


CONCLUSIONS
Patients with diabetes are at a higher risk of mortality after LVAD implantation.
Butler
Javed
J
Cardiology Division, Vanderbilt University, Nashville, Tennessee 37232, USA.
Howser
Renee
R
Portner
Peer M
PM
Pierson
Richard N
RN
D000328:Adult; D002423:Cause of Death; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology