Impact of post-procedural glycemic variability on cardiovascular morbidity and mortality after transcatheter aortic valve implantation: a post hoc cohort analysis

BackgroundGlycemic variability is associated with worse outcomes after cardiac surgery, but the prognosis value of early glycemic variability after transcatheter aortic valve implantation is not known. This study was therefore designed to analyze the prognosis significance of post-procedural glycemic variability within 30days after transcatheter aortic valve implantation.MethodsA post hoc analysis of patients from our center included in the FRANCE and FRANCE-2 registries was conducted. Post-procedural glycemic variability was assessed by calculating the mean daily blood glucose during the first 2days after transcatheter aortic valve implantation. Major complications within 30days were death, stroke, myocardial infarction, acute heart failure, and life-threatening cardiac arrhythmias.ResultsWe analyzed 160 patients (age (median [interquartile]=84 [80-88] years; diabetes mellitus (n)=41 (26%) patients; logistic Euroscore=20 [12-32]). The median value of mean daily blood glucose was 4.3mmoll(-1). The rate of major complications within 30days after procedure among patients with the lowest quartile of glycemic variability was 12%, increasing from 12 to 26%, and 39% in the second, third, and fourth quartiles, respectively. In multivariate analysis, glycemic variability was independently associated with an increased risk of major complications within 30days after the procedure (odds ratio [95% CI]=1.83 [1.19-2.83]; p=0.006).ConclusionsThis study showed that post-procedural glycemic variability was associated with an increased risk of major complications within 30days after transcatheter aortic valve implantation.Trial registration Clinical trial registration number https://www.clinicaltrials.gov/; identifier: NCT02726958; date: April 4th, 2016