Percutaneous Left Atrial Appendage Closure Among Patients With Diabetes (Insights from a National Database)

Atrial fibrillation is a major risk factor for stroke. Left atrial appendage closure (LAAC) has emerged as an alternative to anticoagulation for patients with high risk of bleeding. Diabetes mellitus (DM) is associated with adverse events after cardiac procedures. We sought to compare procedural and...

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Bibliographic Details
Published in:The American journal of cardiology 2023-09, Vol.202, p.144-150
Main Authors: Hamed, Mohamed, Morcos, Ramez, Elbadawi, Ayman, Osman, Ahmed, Jneid, Hani, Khalife, Wissam, Maini, Brijeshwar, Khalili, Houman
Format: Article
Language:English
Subjects:
Adverse events
Anemia
Anticoagulants
Atrial Appendage - surgery
Atrial Fibrillation - complications
Atrial Fibrillation - epidemiology
Atrial Fibrillation - surgery
Blood transfusion
Blood transfusions
Cardiovascular disease
Cerebral infarction
Coronary vessels
Diabetes
Diabetes Mellitus
Disease prevention
Effusion
Fibrillation
Health risks
Heart
Hemorrhage
Hospital Mortality
Hospitalization
Hospitals
Humans
Length of stay
Liver diseases
Myocardial infarction
Nursing homes
Regression analysis
Retrospective Studies
Risk factors
Stroke
Stroke - epidemiology
Stroke - etiology
Stroke - prevention & control
Tamponade
Thromboembolism
Transient ischemic attack
Treatment Outcome
Vein & artery diseases
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Summary:Atrial fibrillation is a major risk factor for stroke. Left atrial appendage closure (LAAC) has emerged as an alternative to anticoagulation for patients with high risk of bleeding. Diabetes mellitus (DM) is associated with adverse events after cardiac procedures. We sought to compare procedural and hospital outcomes in patients who underwent LAAC with and without DM. The Nationwide Inpatient Database was queried for patients with atrial fibrillation who underwent LAAC between January 1, 2016, and December 31, 2019. The primary outcome was all adverse events that included in-hospital death, acute myocardial infarction, cardiac arrest, stroke, pericardial effusion, pericardial tamponade, pericardiocentesis, pericardial window, and postprocedural hemorrhage requiring blood transfusion. Analysis included 62,220 patients who underwent LAAC from 2016 to 2019; 34.9% of patients had DM. There was a slight increase in the percentage of patients who underwent LAAC who had DM during the study period, from 29.92% to 34.93%. In unadjusted and adjusted analysis, there was no significant difference in all adverse events between patients with and without DM who underwent LAAC (9.18% vs 8.77%, respectively, adjusted p = 0.63), and no difference in length of stay. Patients with DM have higher risk of acute kidney injury (3.75 vs 1.96%, p 
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.06.054