Clinical features and prognosis of patients with and without diabetes mellitus undergoing endovascular aortic aneurysm repair.

Autor: Takahara M; Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan. takahara@endmet.med.osaka-u.ac.jp., Iida O; Cardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki City, Hyogo, 660-8511, Japan., Tazaki J; Department of Cardiovascular Medicine and Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8501, Japan., Nishikawa R; Department of Cardiovascular Medicine, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, Shizuoka, 420-8527, Japan., Nanto K; Cardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki City, Hyogo, 660-8511, Japan., Chiba Y; Department of Cardiology, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito City, , Ibaraki, 311-4198, Japan., Sakamoto K; Department of Cardiovascular Medicine and Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8501, Japan., Kinoshita M; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe-city, Hyogo, 650-0047, Japan., Takahashi N; Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasakicho, Tennoji-ku, Osaka City, Osaka, 543-8555, Japan., Kamihira S; Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo City, Shimane, 693-8555, Japan., Yamaoka T; Department of Vascular Surgery, Matsuyama Red Cross Hospital, 1 Bunkyocho, Matsuyama City, Ehime, 790-0826, Japan., Higami H; Department of Cardiovascular Medicine, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu City, Shiga, 520-0046, Japan., Nakane T; Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, 1 Katsuragosho-cho, Nishikyo-ku, Kyoto City, Kyoto, 615-8087, Japan., Ohmine T; Department of Vascular Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6 Sendamachi, Naka-ku, Hiroshima City, Hiroshima, 730-8619, Japan., Guntani A; Department of Vascular Surgery, Saiseikai Yahata General Hospital, 5-9-27 Harunomachi, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-0050, Japan.
Jazyk: angličtina
Zdroj: BMC endocrine disorders [BMC Endocr Disord] 2022 Apr 07; Vol. 22 (1), pp. 92. Date of Electronic Publication: 2022 Apr 07.
DOI: 10.1186/s12902-022-01008-4
Abstrakt: Background: This study aimed to compare the clinical features and prognoses of patients with and without diabetes mellitus (DM) who underwent endovascular repair for aortic aneurysm (AA).
Methods: We analyzed the clinical database of a prospective multicenter study, registering 929 patients who underwent their first endovascular AA repair in Japan between January 2016 and June 2018. The baseline characteristics and prognoses (including all-cause mortality and cardiovascular events) after repair were compared between the DM and non-DM groups. Prognoses were also compared between the groups after propensity score matching.
Results: In total, 226 patients (24.3%) had DM. Compared with non-DM patients, DM patients had higher pack-years of smoking (P = 0.011), higher body mass index (P = 0.009), lower high-density lipoprotein cholesterol levels (P = 0.038), higher triglyceride levels (P = 0.025), and lower left ventricular ejection fraction (P = 0.005). Meanwhile, the low-density lipoprotein cholesterol and blood pressure levels showed no significant intergroup difference (all P > 0.05). DM patients had a higher prevalence of myocardial infarction (P = 0.016), history of coronary revascularization (P = 0.015), and lower extremity artery disease (P = 0.019). Lesion characteristics and procedures were similar between the groups (all P > 0.05). DM patients had a higher risk of all-cause mortality and cardiovascular events than non-DM patients (both P < 0.001). Subsequent propensity score matching also demonstrated that DM patients had a significantly lower rate of overall survival (P = 0.001) and freedom from cardiovascular events (P = 0.010). The Kaplan-Meier estimates at 1 year for the overall survival were 85.6% (95% confidence interval [CI], 80.9% to 90.5%) and 94.3% (95% CI, 91.7% to 97.0%) for patients with and without DM, respectively. The corresponding estimates for freedom from cardiovascular events were 79.8% (95% CI, 74.5% to 85.5%) and 87.7% (95% CI, 84.2% to 91.3%), respectively.
Conclusions: Among patients undergoing endovascular AA repair, those with DM had more cardiovascular risk factors. DM patients had a higher incidence rate of all-cause mortality and cardiovascular events. Matching analysis indicated that DM per se would be a risk factor for poor prognoses after AA repair.
(© 2022. The Author(s).)
Databáze: MEDLINE
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