The effect of diabetes mellitus on aortic valve stenosis and its treatment outcome: A meta-analysis review

Abstract

BACKGROUND: Given the importance of diabetes mellitus (DM) and its role in the development of aortic valve stenosis (AVS), as well as its association with adverse outcomes after aortic valve replacement (AVR), the present meta analysis aimed to provide a comprehensive review of previous studies in this field. METHODS: To achieve this objective, a thorough literature search was conducted in PUBMED/MEDLINE, ScienceDirect, CINAHL, EMBASE/SCOPUS, PsycINFO, ClinicalKey, the Cochrane Central Register of Controlled Trials (CENTRAL), ProQuest, Web of Science, and Persian databases such as SID and Magiran. The number of patients, gender ratio, mean age, prevalence of T2DM, AVS, and treatment outcomes after TAVI, TAVR, and SAVR (stroke, early and late mortality) were recorded. RESULTS: This meta-analysis comprised 22 studies involving a total of 760,287 patients with AVS. The pooled prevalence of DM was approximately 31 (95 CI: 26-36). DM was associated with a significantly higher risk of early mortality, including both in-hospital mortality (OR: 2.399) and 30-day mortality (OR: 1.45), compared with non-DM patients (p<0.05). However, the increase in late mortality (one year or longer) among DM patients was not statistically significant. Additionally, DM patients showed a significantly elevated risk of stroke compared with non-DM patients (OR: 1.15; 95 CI: 1.03-1.28; p=0.009). CONCLUSION: Overall, DM appears to play a significant role in the development of AVS and is associated with adverse outcomes including mortality and stroke after AVR.