Impact of diabetes mellitus on female subjects undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI international registry.
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Goel Ridhima, Sartori Samantha, Cao Davide, Claessen Bimmer E, Baber Usman, Chandiramani Rishi, Nicolas Johny, Roumeliotis Anastasios, Power David, Chandrasekhar Jaya, Tchetche Didier, Petronio Anna Sonia, Mehilli Julinda, Lefevre Thierry, Presbitero Patrizia, Capranzano Piera, Iadanza Alessandro, Sardella Gennaro, Van Mieghem Nicolas M, Meliga Emanuele, Dumonteil Nicolas, Fraccaro Chiara, Trabattoni Daniela, Mikhail Ghada W, Ferrer-Gracia Maria-Cruz, Naber Christoph, Sharma Samin, Morice Marie-Claude, Dangas George D, Chieffo Alaide, Mehran Roxana
Аннотация
METHOD: WIN-TAVI is a real-world international registry of exclusively female subjects undergoing TAVI. The study population was stratified into those with (DM) and those without DM (NDM). Valve Academic Research Consortium (VARC)-2 efficacy (composite of all-cause death, stroke, myocardial infarction, hospitalization for valve-related symptoms or worsening congestive heart failure, or valve-related dysfunction) was the primary endpoint for this analysis.
RESULTS: Of the 1012 subjects included in this study, 264 (26.1%) had DM at baseline. DM patients were younger but had a higher burden of comorbidities. There were no differences in VARC-2 efficacy events between DM and NDM patients at 30 days or 1 year. Conversely, patients with DM had a lower risk of VARC-2 life threatening bleeding at 30 days and 1 year after TAVI compared to NDM patients, which remained significant even after multivariable adjustment (HR, 0.34, 95% CI, 0.12-0.99; p = .047). In the subgroup analysis, insulin-dependent DM was not associated with an increased risk of adverse outcomes.
CONCLUSIONS: Among female patients undergoing TAVI, more than one-fourth of the subjects presented with DM. At 1-year follow-up, DM was associated with lower bleeding complications and no increase in the risk of other adverse events, including mortality, after TAVI.