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Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR) are conflicting.
We searched Pubmed/Medline and Cochrane Central Register of Controlled Trials for all studies that evaluated outcomes after TAVR and stratified at least one of the studied endpoints by DM status. Primary end point was all-cause mortality at one year. Secondary end points were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accidents (CVAs), major bleeding and major vascular complications. Pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using random effect models.
The present meta-analysis included 64 studies with a total of 38,686 patients. DM was present in 29% of those patients. Patients with DM had significantly higher one year mortality (OR 1.14, CI 1.04-1.26, p=0.008) and periprocedural AKI (OR: 1.28, CI: 1.08-1.52, p=0.005) when compared to patients without DM. On the other hand, there were no significant differences between diabetics and non-diabetics in early mortality (OR 1.00, CI 0.86-1.16, p=0.99), CVAs (OR 1.01, CI 0.63-1.64, p=0.95), major bleeding (OR 1.03, CI 0.84-1.25, p=0.79) or major vascular complications (OR 0.89, CI 0.65-1.22, p=0.47).
In patients undergoing TAVR, DM is associated with increased one-year mortality and periprocedural AKI, and therefore, DM should be considered one of the predictors of adverse outcomes in those patients.
STRUCTURAL: Valvular Disease: Aortic