[Diabetes increases short- and long-term mortality after transcatheter aortic valve implantation (TAVI)].
OBJECTIVE
Long-term mortality after transcatheter aortic valve implantation (TAVI) in elderly patients with abundant comorbidities is considerable. We aimed to determine the impact of diabetes on short- and long-term mortality after TAVI.


METHODS
Our study includes 300 consecutive patients (mean age, 82 ± 5 years) who underwent TAVI (158 transapical, 142 transfemoral procedures). All patients were followed by regular telephone contacts. 36% suffered from diabetes.


RESULTS
Diabetes could be identified as significant predictor of short- and long-term mortality after TAVI. In diabetic patients, 30-day-mortality was 2,5 fold elevated (18.3% vs. 7.3%, p = 0.004). Furthermore, they were at significantly higher risk of peri-interventional stroke (p = 0.04), stage 3 acute kidney injury (p = 0.003), and prolonged ventilation (p = 0.01). Even after successful TAVI and discharge from hospital, long-term mortality was significantly elevated in diabetic patients (56% vs. 30%, p < 0.0001). Of note, 25% of diabetic vs. only 8% of non-diabetic patients died from cardiac causes during follow-up, suggesting that TAVI is not able to reduce cardiac-related mortality risk in diabetic patients to the same extent as in non-diabetics.


CONCLUSIONS
Diabetes represents a powerful predictor of adverse early and late outcome after TAVI. These findings should be incorporated into the assessment of the risk-to-benefit ratio of TAVI in diabetic patients.
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
M
M
Puls
Abteilung Medizinische Statistik, Universitätsmedizin Göttingen.
A
A
Bleckmann
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
C
C
Jacobshagen
Klinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsmedizin Göttingen.
B C
BC
Danner
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
G
G
Hasenfuß
Klinik für Thorax-, Herz- und Gefäßchirurgie, Universitätsmedizin Göttingen.
R
R
Seipelt
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
W
W
Schillinger
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization; D015897:Comorbidity; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000401:mortality*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D012307:Risk Factors