Meta-Analysis Comparing Risk for Adverse Outcomes After Left Ventricular Assist Device Implantation in Patients With Versus Without Diabetes Mellitus

Noman Lateef, Muhammad Shariq Usman, Paolo C. Colombo, Saba Ahmed, Muhammad Shahzeb Khan, Safi U. Khan, Arthur R. Garan, Melana Yuzefpolskaya, Ryan T. Demmer

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with diabetes mellitus (DM) are known to have reduced life expectancy and be at increased risk for multiple morbidities including serious infection. However, published data on DM outcomes after left ventricular assist device (LVAD) implantation are sparse, inconsistent and individual studies are small with limited power. We conducted a systematic review and meta-analysis to compare survival and adverse events post-LVAD in DM versus non-DM (NDM) patients. Medline, Scopus, and Cochrane Central databases were searched for studies comparing outcomes in DM and NDM patients who underwent LVAD implantation for advanced heart failure. Results were reported as random effect risk ratios (RR) with 95% confidence intervals. We identified 5 retrospective cohort studies, at low risk of bias, reporting on 1,351 patients (n = 488 DM). There was increased 30-day mortality (RR 1.57 [1.00, 2.47]; p = 0.05; I2 = 0%) among DM versus NDM. The DM and NDM groups did not differ significantly in terms of 1-year mortality (RR 1.15 [0.98, 1.35]; p = 0.08; I2 = 39%), device-related infection (RR 1.05 [0.92, 1.19]; p = 0.88; I2 = 0%), ischemic stroke (RR 1.29 [0.91, 1.83]; p = 0.69; I2 = 0%), hemorrhagic stroke (RR 1.10 [0.42, 2.83]; p = 0.85; I2 = 69%), or bleeding (RR 1.06 [0.80, 1.40]; p = 0.70; I2 = 27%). After LVAD implantation, patients with DM, versus patients without, have a modestly elevated 30-day mortality rate. However, 1-year mortality and morbidity did not differ.

Original languageEnglish (US)
Pages (from-to)1918-1923
Number of pages6
JournalAmerican Journal of Cardiology
Volume124
Issue number12
DOIs
StatePublished - Dec 15 2019

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article
  • Meta-Analysis
  • Systematic Review

Fingerprint Dive into the research topics of 'Meta-Analysis Comparing Risk for Adverse Outcomes After Left Ventricular Assist Device Implantation in Patients With Versus Without Diabetes Mellitus'. Together they form a unique fingerprint.

Cite this