Abstract 13252: The Effects of Pre-LVAD Diabetes on Post-LVAD Outcomes

Abstract

Introduction: Diabetes Mellitus (DM) is a major risk factor for adverse cardiovascular (CV) outcomes. In this study, we investigated the effects of DM on post HeartMate II left ventricular assist device (LVAD) outcomes. Methods: In this retrospective study, 244 patients (Pts) were enrolled. Pts were stratified based on the presence or absence of pre-LVAD DM. DM was defined as a pre-existing history of DM requiring insulin or oral hypoglycemic medications or a new diagnosis of DM based on HgbA1C> 7mg/DL. Baseline information and post adverse outcomes were tabulated. Results: The cohort comprised of 108 diabetics and 136 non-diabetics. DM pts had a slightly worse baseline medical profile than non-DM. DM pts were more likely to be obese, had worse creatinine, and higher systolic and mean arterial blood pressure. DM pts also had a higher prevalence of atrial fibrillation, obstructive sleep apnea, and renal insufficiency. HgbAIC profiles revealed sub-optimal diabetic control at baseline (Table1). Post-LVAD, other than a higher incidence of hemolysis in the diabetic pts (12% vs 4%; p= 0.03), there were no differences between the two groups. Post LVAD HgbA1C was statistically significantly better (7.2 vs 6.1 P-value <0.001). Conclusions: Although DM is a poor risk factor for many adverse CV outcomes, there are no differences in adverse events in our pts post-LVAD placement compared to non-diabetic pts. This may be a result of improved access to care for diabetics, improvement in hemodynamics and biochemical derangements after normalization of cardiac output, or increased pancreatic blood flow. Our results indicate that diabetic pts who receive LVAD therapy are overall not at higher risk for adverse outcomes compared to non-diabetics. Further larger prospective studies are needed to validate our findings.