AI Article Synopsis
- Diabetes mellitus (DM) is shown to negatively impact long-term outcomes in elderly patients with valvular heart disease (VHD), increasing risks of major adverse events.
- In a study of 532 elderly VHD patients over nearly 53 months, those with DM experienced significantly higher rates of ischemic stroke, heart failure rehospitalization, and overall adverse cardiac events compared to non-DM patients.
- Surprisingly, for patients with rheumatic VHD, DM acted as a protective factor against these events, contrasting with its negative effects in other cases.
Article Abstract
Background: Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients.
Methods: This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization.
Results: Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group ( = 377), the DM group ( = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, =0.001), heart failure rehospitalization (37.4% vs. 20.7%, < 0.001), and MACCEs (60.0% vs. 35.8%, < 0.001). After adjustment of confounders by the multivariable cox regression, DM appeared as an independent predictor for MACCEs (adjusted hazard ratio, aHR: 1.88; 95% confidence interval 1.42-2.48; < 0.001). In the subgroup analysis of VHD etiology and functional style, conversely, DM was a protective factor for MACCEs in the patients with rheumatic VHD compared with those without rheumatic VHD (aHR: 0.43 vs. 2.27, =0.004).
Conclusions: DM was an independent predictor for ischemic stroke and heart failure rehospitalization in elderly VHD patients undergoing conservative treatment.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8566085 | PMC |
| http://dx.doi.org/10.1155/2021/2558639 | DOI Listing |
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