Post-Implant Outcomes in Diabetic vs. Non-Diabetic Durable LVAD Patients.

The purpose of this study was to determine the difference in survival, adverse event frequency, and overall outcomes in diabetic (DM) versus non-diabetic (non-DM) patients following the implant of a left-ventricular assist device (LVAD). We hypothesized that the DM population would have a higher mortality rate, greater frequency of renal injury or failure, and a greater frequency of post-operative infections. We performed a retrospective analysis of 176 LVAD patients (100 non-DM and 76 DM) from our institution from 2016 to 2021. Descriptive statistics and Kaplan-Meier survival functions were employed to examine the differences in 1-year survival, renal outcomes, adverse events, and time to heart transplantation between the groups. Both cohorts were evenly matched for sex, race, age, heart failure etiology, and baseline functional status. Severe acute kidney injuries (as defined by a 300% increase in serum creatinine, serum creatinine > 4.0 mg/dl, urine output <0.3 ml/kg/h for >24 hours, anuria for >12 hours, or need for renal replacement therapy) occurred at a greater frequency (6 vs. 11 patients, p=0.049) in the DM VAD population than the non-DM population during support. Discharge status, change in Hgb-A1c and creatinine, occurrence of infection, duration of LVAD support, bleeding events, neurological events, time to transplant, hospital and ICU length of stay, and overall outcome did not differ significantly between groups. 1-year survival and the length of time to a heart transplant as plotted by Kaplan-Meier curves both did not differ significantly between the DM and non-DM groups (p=0.8171, p=0.4385). Although severe acute kidney injury events occurred at a greater frequency in the DM population, other important outcomes (including survival, adverse event frequency, and time to heart transplant) were equivalent between DM and non-DM groups. This preliminary data suggests that DM status in heart failure patients may not be a predictor of a worse outcomes for LVAD patients. [ABSTRACT FROM AUTHOR]