PMID- 29121921 OWN - NLM STAT- MEDLINE DCOM- 20180620 LR - 20181113 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 16 IP - 1 DP - 2017 Nov 9 TI - Transcatheter aortic valve implantation and surgical aortic valve replacement among hospitalized patients with and without type 2 diabetes mellitus in Spain (2014-2015). PG - 144 LID - 10.1186/s12933-017-0631-6 [doi] LID - 144 AB - BACKGROUND: Type 2 diabetes mellitus (T2DM) is strongly related to the in-hospital and short-term prognosis in patients with cardiovascular diseases needing surgical or invasive interventions. How T2DM might influence the treatment of aortic stenosis (AS) has not been completely elucidated for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). The aims of this study were: (1) to describe the use of aortic valve replacement procedures (TAVI and SAVR) among hospitalized patients with and without T2DM; and (2) to identify factors associated with in hospital mortality (IHM) among patients undergoing these procedures. METHODS: We analyzed data from the Spanish National Hospital Discharge Database between January 1, 2014 and December 31, 2015 for patients aged >/= 40 years. We selected patients whose medical procedures included TAVI (ICD-9-CM codes 35.05, 35.06) and SAVR (ICD-9-CM codes 35.21, 35.22). We stratified each cohort by diabetes status: T2DM (ICD-9-CM codes 250.x0, 250.x2) and no diabetes. We retrieved data about specific comorbidities, risk factors, procedures, and specific in-hospital postoperative complications. Hospital outcome variables included IHM, and length of hospital stay (LOHS). RESULTS: We identified a total of 2141 and 16,013 patients who underwent TAVI (n = 715; 33.39% with T2DM) and SAVR (n = 4057; 25.33% with T2DM). In patients who underwent TAVI we found no differences in IHM (3.64% in T2DM vs. 5.12% in non-T2DM, p = 0.603). In the cohort of SAVR, mean LOHS was significantly lower in patients with T2DM than in non-diabetic patients (13.77 vs. 17.27 days). IHM was lower in patients with T2DM (4.36% vs. 6.31%, p < 0.01). After multivariable adjustment for both procedures, patients with T2DM had significantly lower IHM than patients without diabetes (adjusted OR 0.60; IC 95% 0.37-0.99 for TAVI and adjusted OR 0.80; IC 95% 0.66-0-96 for SAVR). CONCLUSIONS: T2DM diabetic patients with AS undergoing a valvular replacement procedure through SAVR or TAVI did not have a worse prognosis compared to non-diabetic patients during hospitalization, showing lower IHM after multivariable adjustment. However, given the limitations of administrative data more prospective studies and clinical trials aimed at evaluating the influence of these procedures in diabetic patients with AS are needed. FAU - Mendez-Bailon, Manuel AU - Mendez-Bailon M AD - Internal Medicine Department, Instituto de Investigacion Cardiovascular, Hospital Clinico San Carlos, Complutense University, Madrid, Spain. FAU - Lorenzo-Villalba, Noel AU - Lorenzo-Villalba N AD - Service de Medicine Interne et Cancerlogie, Centre Hospitalier Saint Cyr, Lyon, France. FAU - Munoz-Rivas, Nuria AU - Munoz-Rivas N AD - Internal Medicine Department, Hospital Universitario Infanta Leonor, Madrid, Spain. FAU - de Miguel-Yanes, Jose Maria AU - de Miguel-Yanes JM AD - Internal Medicine Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - De Miguel-Diez, Javier AU - De Miguel-Diez J AD - Pneumology Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Comin-Colet, Josep AU - Comin-Colet J AD - Department of Cardiology, Hospital Universitario de Bellvitge, Barcelona, Spain. FAU - Hernandez-Barrera, Valentin AU - Hernandez-Barrera V AD - Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcon, Madrid, Spain. FAU - Jimenez-Garcia, Rodrigo AU - Jimenez-Garcia R AD - Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcon, Madrid, Spain. rodrigo.jimenez@urjc.es. FAU - Lopez-de-Andres, Ana AU - Lopez-de-Andres A AD - Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcon, Madrid, Spain. LA - eng GR - PI16/00564/FIS (Fondo de Investigaciones Sanitarias-Health Research Fund, Instituto de Salud Carlos III) co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, "Una manera de hacer Europa")/ GR - 30VCPIGI03/Grupo de Excelencia Investigadora URJC-Banco Santander: Investigacion traslacional en el proceso de salud - enfermedad (ITPSE)./ PT - Comparative Study PT - Journal Article DEP - 20171109 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Aortic Valve Stenosis/diagnosis/*epidemiology/*surgery MH - Databases, Factual/trends MH - Diabetes Mellitus, Type 2/diagnosis/*epidemiology/*surgery MH - Female MH - Heart Valve Prosthesis Implantation/*trends MH - Hospitalization/*trends MH - Humans MH - Male MH - Middle Aged MH - Spain/epidemiology MH - Transcatheter Aortic Valve Replacement/trends PMC - PMC5679322 OTO - NOTNLM OT - Hospital OT - Mortality OT - Surgical aortic valve replacement OT - Transcatheter aortic valve implantation OT - Type 2 diabetes EDAT- 2017/11/11 06:00 MHDA- 2018/06/21 06:00 PMCR- 2017/11/09 CRDT- 2017/11/11 06:00 PHST- 2017/08/25 00:00 [received] PHST- 2017/11/02 00:00 [accepted] PHST- 2017/11/11 06:00 [entrez] PHST- 2017/11/11 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2017/11/09 00:00 [pmc-release] AID - 10.1186/s12933-017-0631-6 [pii] AID - 631 [pii] AID - 10.1186/s12933-017-0631-6 [doi] PST - epublish SO - Cardiovasc Diabetol. 2017 Nov 9;16(1):144. doi: 10.1186/s12933-017-0631-6.