American heart journal plus : cardiology research and practice · 2025
Impact of diabetes mellitus type-2 on the outcomes following mitral transcatheter edge-to-edge repair (TEER): A meta-analysis.
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Chigurupati Himaja Dutt, Neppala Sivaram, Chikatimalla Rahul, Fath Ayman, Upreti Prakash, Bolte Jeffery, Naveed Muhammad Abdullah, Rao Adishwar, Altaee Osama, Sattar Yasar, Desai Rupak, DeFronzo Ralph A, Rana Jamal S, Paul Timir K
Аннотация
BACKGROUND: Diabetes mellitus (DM) has been linked to unfavorable outcomes in patients undergoing Mitral Transcatheter Edge-to-Edge Repair (TEER). Nevertheless, the literature contains conflicting data. This meta-analysis aimed to assess the impact of DM on outcomes following Mitral TEER.
METHODS: We searched PubMed, Scopus, and Medline for studies reporting outcomes following mitral TEER in diabetic and non-diabetic patients. Using a random-effects model, we determined the pooled odds ratio (OR) for clinical outcomes in patients who underwent Mitral TEER, regardless of their diabetes status.
RESULTS: We included four studies with 2130 patients. DM was present in 31 % of the population, with a mean age of 73.9 (±8.2) years, 50.2 % of males, and 30 % of the population being obese. Patients with DM were more likely to be obese compared to patients without DM. In this meta-analysis, individuals with DM exhibited a higher 30-day MACCE (OR: 1.50, 95 % CI: 1.08-2.09, p = 0.02) and all-cause recurrent hospitalizations (OR: 1.36, 95 % CI: 1.07-1.72, p = 0.01) compared to those without diabetes. However, the difference in 30-day all-cause mortality (OR: 1.20, 95 % CI: 0.92-1.56, p = 0.19) and in-hospital all-cause mortality (OR: 0.92, 95 % CI: 0.51-1.67, p = 0.78) was not statistically significant between the two groups.
CONCLUSION: DM is associated with an increased risk of 30-day MACCE and recurrent hospitalizations following Mitral TEER. Consequently, DM should be regarded as a predictor of adverse outcomes. Future, well-designed prospective randomized trials are necessary to evaluate the mid-term impact of DM on MACCE.
METHODS: We searched PubMed, Scopus, and Medline for studies reporting outcomes following mitral TEER in diabetic and non-diabetic patients. Using a random-effects model, we determined the pooled odds ratio (OR) for clinical outcomes in patients who underwent Mitral TEER, regardless of their diabetes status.
RESULTS: We included four studies with 2130 patients. DM was present in 31 % of the population, with a mean age of 73.9 (±8.2) years, 50.2 % of males, and 30 % of the population being obese. Patients with DM were more likely to be obese compared to patients without DM. In this meta-analysis, individuals with DM exhibited a higher 30-day MACCE (OR: 1.50, 95 % CI: 1.08-2.09, p = 0.02) and all-cause recurrent hospitalizations (OR: 1.36, 95 % CI: 1.07-1.72, p = 0.01) compared to those without diabetes. However, the difference in 30-day all-cause mortality (OR: 1.20, 95 % CI: 0.92-1.56, p = 0.19) and in-hospital all-cause mortality (OR: 0.92, 95 % CI: 0.51-1.67, p = 0.78) was not statistically significant between the two groups.
CONCLUSION: DM is associated with an increased risk of 30-day MACCE and recurrent hospitalizations following Mitral TEER. Consequently, DM should be regarded as a predictor of adverse outcomes. Future, well-designed prospective randomized trials are necessary to evaluate the mid-term impact of DM on MACCE.