Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement
Background Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR.Methods Data w...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003019.full |
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| author | Soha Dargham Amin Jayyousi Jassim Al Suwaidi Charbel Abi Khalil Ahston D Souza Khalifa Bsheish |
| author_facet | Soha Dargham Amin Jayyousi Jassim Al Suwaidi Charbel Abi Khalil Ahston D Souza Khalifa Bsheish |
| author_sort | Soha Dargham |
| collection | DOAJ |
| description | Background Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR.Methods Data were extracted from the Nationwide Readmissions Database from 2012 to 2017. The primary outcome was 30-day mortality, and the secondary outcome was 30-day readmission.Results The study included 110 135 patients who underwent aortic valve replacement. Of these, 59 466 (54.0%) were hospitalised for TAVR, and 50 669 (46.0%) underwent sAVR. Diabetes was present in 36.4% of TAVR patients and 29.1% of sAVR patients. In TAVR patients, the adjusted risk of 30-day readmission and mortality was similar regardless of diabetes status (aHR=0.94 (0.86–1.03); 0.97 (0.84–1.12); respectively). However, sAVR patients with diabetes had a higher adjusted risk of 30-day mortality (aHR=1.13 (1.01–1.25)) but not readmission (aHR=0.92 (0.84–1.01)). When comparing outcomes between TAVR and sAVR in patients with diabetes, TAVR patients were older and had a higher prevalence of chronic kidney disease (CKD). Nevertheless, 30-day readmission and mortality were lower in patients who underwent TAVR (aHR=0.59 (0.53–0.67), aHR=0.29 (0.25–0.34), respectively) compared with sAVR. Coronary artery disease was the most significant predictor of readmission in patients with diabetes. CKD increased the risk of mortality by almost twofold in both techniques.Conclusion Diabetes increases the risk of short-term mortality in sAVR but not TAVR. Moreover, the incidence of 30-day mortality and readmission is lower in TAVR compared with TAVR among patients with diabetes. |
| format | Article |
| id | doaj-art-8cbeebb8007b4a2e9f39c45c3037dfb8 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-8cbeebb8007b4a2e9f39c45c3037dfb82025-01-15T03:00:10ZengBMJ Publishing GroupOpen Heart2053-36242025-01-0112110.1136/openhrt-2024-003019Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacementSoha Dargham0Amin Jayyousi1Jassim Al Suwaidi2Charbel Abi Khalil3Ahston D Souza4Khalifa Bsheish5Department of Medical Education, Weill Cornell Medicine – Qatar, Doha, QatarDepartment of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Ad Dawhah, QatarBiostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar1 Department of Medicine, Weill Cornell Medicine, Doha, QatarResearch Department, Weill Cornell Medicine—Qatar, Doha, QatarResearch Department, Weill Cornell Medicine—Qatar, Doha, QatarBackground Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR.Methods Data were extracted from the Nationwide Readmissions Database from 2012 to 2017. The primary outcome was 30-day mortality, and the secondary outcome was 30-day readmission.Results The study included 110 135 patients who underwent aortic valve replacement. Of these, 59 466 (54.0%) were hospitalised for TAVR, and 50 669 (46.0%) underwent sAVR. Diabetes was present in 36.4% of TAVR patients and 29.1% of sAVR patients. In TAVR patients, the adjusted risk of 30-day readmission and mortality was similar regardless of diabetes status (aHR=0.94 (0.86–1.03); 0.97 (0.84–1.12); respectively). However, sAVR patients with diabetes had a higher adjusted risk of 30-day mortality (aHR=1.13 (1.01–1.25)) but not readmission (aHR=0.92 (0.84–1.01)). When comparing outcomes between TAVR and sAVR in patients with diabetes, TAVR patients were older and had a higher prevalence of chronic kidney disease (CKD). Nevertheless, 30-day readmission and mortality were lower in patients who underwent TAVR (aHR=0.59 (0.53–0.67), aHR=0.29 (0.25–0.34), respectively) compared with sAVR. Coronary artery disease was the most significant predictor of readmission in patients with diabetes. CKD increased the risk of mortality by almost twofold in both techniques.Conclusion Diabetes increases the risk of short-term mortality in sAVR but not TAVR. Moreover, the incidence of 30-day mortality and readmission is lower in TAVR compared with TAVR among patients with diabetes.https://openheart.bmj.com/content/12/1/e003019.full |
| spellingShingle | Soha Dargham Amin Jayyousi Jassim Al Suwaidi Charbel Abi Khalil Ahston D Souza Khalifa Bsheish Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement Open Heart |
| title | Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| title_full | Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| title_fullStr | Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| title_full_unstemmed | Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| title_short | Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| title_sort | diabetes is associated with a higher incidence of short term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement |
| url | https://openheart.bmj.com/content/12/1/e003019.full |
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