Diabetes cuts long-term survival after surgery for infective endocarditis

Israel: Diabetes cuts long-term survival after surgery for infective endocarditis, finds a new study. Diabetes, regardless of age or comorbidities, is an independent predictor of long-term, 5-year mortality after surgical treatment of endocarditis.

The research has been published in Research Square.

Diabetes mellitus type 2 (DM) is a common comorbidity in people with infective endocarditis (IE). This study conducted by Alexander Kogan and the team looked at the effect of type 2 diabetes on the early, intermediate, and long-term mortality of individuals who had endocarditis surgically treated.

During 14 years, researchers conducted an observational cohort in a big tertiary facility in Israel. All data from patients who underwent endocarditis surgery between 2006 and 2020 were taken from the departmental database. Patients were separated into two groups: Group I (non-diabetic patients) and Group II (diabetic patients) (diabetic patients). The authors assessed the relationship between diabetes and mortality using a Cox proportional hazards model and multiple strategies to account for baseline between-group differences. Sex, age, damaged valve, diabetes, presence of perioperative heart failure, prior cardiac surgery, and perioperative acute kidney injury were all factors considered in the final model.

The key findings of this study are as follow:

1. There were 420 patients in the trial.

2. Group I (non-diabetic patients) included 326 people, whereas Group II (diabetic patients) had 94 people.

3. The average period of follow-up was 39.3±28.1 months.

4. Short-term, 30-day, and in-hospital mortality, as well as intermediate-term (1- and 3-year) mortality, were greater in the DM group compared to the non-DM group, although not statistically significant: 11.7% vs. 7.7%, 12.8% vs. 8.3%, 20.2% vs. 13.2%, and 23.4% vs. 15.6%.

5. Long-term, 5-year mortality in the DM group was considerably greater than in the non-DM group: 30.9% vs. 16.6%.

6. Diabetes was also found to be a predictor of long-term death, according to regression analysis.

In conclusion, diabetes patients show a trend toward higher mortality after IE surgery in the short and intermediate-term, although this is not statistically significant. Usually, after more than 3 years, diabetes individuals' survival begins to decline.

Reference:

Kogan, A., Wieder, A., Frogel, J., Peled-Potashnik, Y., Raanani, E., & Sternik, L. (2022). Surgical Treatment on Infective Endocarditis: Impact of Diabetes on Mortality. Research Square Platform LLC. https://doi.org/10.21203/rs.3.rs-1379104/v1

Keywords: diabetes, infection, comorbid, cardiovascular diabetology, endocarditis, heart failure, cardiac surgery, mortality, Alexander Kogan, Research Square