Impact of diabetes mellitus on long-term survival after transcatheter mitral valve edge-to-edge repair

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-02-01 DOI:10.1016/j.ijcha.2025.101601

Volker H. Schmitt , Martin Geyer , Sonja Born , Kevin Bachmann , Katharina Schnitzler , Michaela Hell , Alexander R. Tamm , Tobias Friedrich Ruf , Theresa Ann Maria Gößler , Marc A. Rogmann , Omar Hahad , Lukas Hobohm , Johannes Herzog , Johannes Windschmitt , Sören Schwuchow-Thonke , Recha Blessing , Eberhard Schulz , Philipp Lurz , Thomas Münzel , Karsten Keller , Ralph Stephan von Bardeleben

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引用次数: 0

Abstract

Aim

Diabetes mellitus (DM) represents a notable risk factor within surgical and interventional procedures. Data on its influence on survival after Transcatheter Edge-to-Edge Repair (TEER) of Mitral valve Regurgitation (MR) are sparse.

Methods

In a retrospective monocentric assessment after successful treatment of MR using TEER from 06/2010 to 03/2018 patients were stratified for DM. Mortality was analyzed during follow-up using Cox regression analyses.

Results

Of 627 patients (47.0 % females, 88.2 % aged ≥ 70 years, median follow-up 486 days) consecutively included, subjects with DM (N = 174, 27.8 %) had a higher prevalence of comorbidities like obesity (27.3 % vs. 9.2 %, p < 0.001), arterial hypertension (91.4 % vs. 83.7 %, p = 0.013), renal insufficiency (63.8 % vs. 43.9 %, p < 0.001), coronary artery disease (77.0 % vs. 59.8 %, p < 0.001) and peripheral artery disease (14.4 % vs. 8.4 %, p = 0.026). Patients with DM presented with higher median logistic Euroscore I (29.4 % [20.0/43.0] vs. 25.0 % [16.7/36.6], p = 0.001) and more severely reduced systolic function (LVEF 35 % [30/50] vs. 45 % [30/55], p < 0.001). No difference in short- and long-term survival was detected between patients with and without DM (in-hospital mortality 1.7 vs. 2.6 %, p = 0.771; at 30-days 5.0 vs. 6.0 %, p = 0.842, 1-year 28.7 vs. 25.0 %, p = 0.419, 3-years 49.2 vs. 44.1 %, p = 0.554, 5-years 69.0 vs. 68.3 %, p = 0.497). The presence of DM was not attributed as an individual risk factor for elevated mortality (HR 1-year 1.17 [95 % CI 0.80–1.71], p = 0.419; HR long-term 1.13 [95 %CI 0.86–1.49], p = 0.373).

Conclusion

Although linked to a more vulnerable clinical profile and despite being factored in common risk factor models, DM was not associated with an elevated short- and long-term mortality after TEER of MR.

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糖尿病对经导管二尖瓣边缘修复术后长期生存的影响

糖尿病（DM）是外科手术和介入性手术中一个值得注意的危险因素。关于其对二尖瓣返流（MR）经导管边缘到边缘修复（TEER）后生存影响的数据很少。方法对2010年6月至2018年3月使用TEER治疗MR成功后的患者进行回顾性单中心评估，并对DM进行分层，随访期间采用Cox回归分析死亡率。结果连续纳入627例患者（女性占47.0%，年龄≥70岁占88.2%，中位随访486天），DM患者（N = 174, 27.8%）的肥胖等合并症患病率较高(27.3% vs. 9.2%, p <；0.001)，动脉高血压（91.4%比83.7%,p = 0.013），肾功能不全(63.8%比43.9%,p <；0.001)，冠状动脉疾病(77.0% vs. 59.8%, p <；0.001)和外周动脉疾病（14.4%比8.4%,p = 0.026）。DM患者的中位logistic Euroscore I较高（29.4% [20.0/43.0]vs. 25.0% [16.7/36.6], p = 0.001），收缩功能更严重(LVEF 35% [30/50] vs. 45% [30/55], p <；0.001)。糖尿病患者和非糖尿病患者的短期和长期生存率无差异(住院死亡率1.7 vs 2.6%, p = 0.771；在30 5.0和6.0%,p = 0.842, 1年期28.7和25.0%,p = 0.419, 3年49.2和44.1%,p = 0.554, 5年69.0和68.3%,p = 0.497)。糖尿病的存在不被认为是死亡率升高的个体危险因素(1年风险比1.17 [95% CI 0.80-1.71], p = 0.419；长期HR为1.13 [95% CI 0.86-1.49], p = 0.373)。结论：尽管糖尿病与更脆弱的临床特征有关，尽管在常见的危险因素模型中被考虑在内，但糖尿病与MR TEER后短期和长期死亡率升高无关。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.