title: Outcomes for Patients With Diabetes After Continuous-Flow Left Ventricular Assist Device Implantation.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a risk factor for mortality among patients with heart failure as well as for patients who undergo cardiothoracic surgery. However it is unknown whether DM is associated with increased mortality or major complications during continuous-flow left ventricular assist device (CF-LVAD) support.
  
  
  RESULTS
  We retrospectively reviewed 300 consecutive adults who received CF-LVADs at a single center in the years 2006-2013; 129 patients had DM before LVAD, as defined by American Diabetes Association criteria (HbA1c ≥6.5% and/or taking DM medications). Compared with the non-DM group, DM patients were older, with a higher pre-LVAD body mass index, more ischemic heart failure etiology, and higher pre-LVAD creatinine. Ninety-three patients died on LVAD support, 43 with DM and 50 without DM (P = .4526). After control for 9 covariates in a Cox proportional hazards model, DM was unassociated with all-cause mortality (hazard ratio 0.883, 95% confidence interval 0.571-1.366; P = .5768). Diabetes was also unassociated with the adverse event end points of stroke/transient ischemic attack, intracerebral hemorrhage, pump thrombosis, and device-related infections.
  
  
  CONCLUSIONS
  Diabetes is common in LVAD recipients (43% of the present cohort) but does not increase mortality or rates of major adverse events during CF-LVAD support.
authors.affiliation: Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio; Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: avest@tuftsmedicalcenter.org.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Vest
authors.affiliation: Transplantation Center, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Mistak
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Rory
authors.initials: R
authors.lastname: Hachamovitch
authors.affiliation: Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio; Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Mountis
authors.affiliation: Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio; Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
authors.affiliation: Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio; Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: James B
authors.initials: JB
authors.lastname: Young
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D006353:Heart-Assist Devices; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Heart failure; diabetes; left ventricular assist device; transplantation