Diabetes as an outcome predictor after heart transplantation
| Autor: | Joana Saraiva, Emília Sola, David Prieto, Manuel J. Antunes |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Blood Glucose Graft Rejection medicine.medical_specialty Time Factors medicine.medical_treatment Renal function Kaplan-Meier Estimate Risk Assessment Outcome predictor Risk Factors Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Hypoglycemic Agents Proportional Hazards Models Retrospective Studies Heart transplantation Chi-Square Distribution medicine.diagnostic_test Portugal business.industry Patient Selection Significant difference Graft Survival Middle Aged Transplantação de Coração medicine.disease Lipids Uric Acid Transplantation Survival Rate Treatment Outcome Heart Transplantation Surgery Transplant patient Cardiology and Cardiovascular Medicine business Lipid profile Biomarkers Immunosuppressive Agents |
| Zdroj: | Interactive cardiovascular and thoracic surgery. 13(5) |
| ISSN: | 1569-9285 |
| Popis: | We aimed to compare post-transplantation morbidity and survival among heart transplant recipients with and without diabetes mellitus. A retrospective review of 141 adult patients submitted to heart transplantation from November 2003 to June 2009 (with a minimum follow-up of one year) was undertaken. The patients were divided into two groups: those with (29%) and those without (71%) pre-transplantation diabetes. Those with diabetes were older (57.6 ± 6.1 vs. 52.3 ± 11.1 years; P=0.020) and had lower creatinine clearance (53.6 ± 15.1 vs. 63.7 ± 22.1; P=0.029). Nine patients died in hospital (6.4%; P=non-significant). No significant differences in lipid profiles (diabetes vs. no diabetes) existed before transplantation or at one year afterwards. Patients with diabetes showed a significant deterioration in their one-year lipid profile (158 ± 43 vs.192 ± 38 mg/dl; P=0.001), although one-year fasting diabetic was lower than before (178 ± 80 vs. 138 ± 45 mg/dl; P=0.016). During the first year, 17 (17%) patients previously free of diabetes developed new-onset diabetes. No significant differences were seen in rejection at one year (14% vs. 20%), infection (31% vs. 33%), new-onset renal dysfunction (8% vs. 14%) or mortality (17% vs. 7%). One-year survival was not significantly different (83% vs. 94%), but there was a significant decrease in the survival of individuals with diabetes at three years (73% vs. 91%; P=0.020). No significant difference was found in one-year survival or in terms of higher morbidity in the heart transplant patients with diabetes, but a longer follow-up showed a significant decrease in survival. Nonetheless, the patients with diabetes benefited significantly from transplantation and should not be excluded from it. |
| Databáze: | OpenAIRE |
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