Diabetes mellitus is associated with increased acute kidney injury and 1-year mortality after transcatheter aortic valve replacement: A meta-analysis.
BACKGROUND
Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR).


HYPOTHESIS
DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR.


METHODS
We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accident (CVA), major bleeding, and major vascular complications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models.


RESULTS
We included 64 studies with a total of 38 686 patients. DM was associated with significantly higher 1-year mortality (OR: 1.14, 95% CI: 1.04-1.26, P = 0.008) and periprocedural AKI (OR: 1.28, 95% CI: 1.08-1.52, P = 0.004). On the other hand, there were no significant differences between diabetics and nondiabetics in early mortality, CVAs, major bleeding, or major vascular complications.


CONCLUSIONS
DM is associated with increased 1-year mortality and periprocedural AKI in patients undergoing TAVR. The results of this study suggest that DM is a predictor of adverse outcomes in patients undergoing TAVR.
['Mina|George S|GS|http://orcid.org/0000-0002-1638-7620', 'Gill|Priyanka|P|', 'Soliman|Demiana|D|', 'Reddy|Pratap|P|', 'Dominic|Paari|P|']
D058186:Acute Kidney Injury D001024:Aortic Valve Stenosis D002561:Cerebrovascular Disorders D003920:Diabetes Mellitus D006470:Hemorrhage D006801:Humans D015999:Multivariate Analysis D016017:Odds Ratio D018570:Risk Assessment D012307:Risk Factors D012720:Severity of Illness Index D013997:Time Factors D065467:Transcatheter Aortic Valve Replacement D016896:Treatment Outcome
Diabetes Mellitus Transcatheter Aortic Valve Replacement Meta-analysis