• Ahmed S Yassin, Ahmed Subahi, Oluwole Adegbala, Hossam Abubakar, Emmanuel Akintoye, Abdelrahman Ahmed, Abdalla Ismail, Ahmed Elhag, Ahmed Kambal, Adedotun Alade, Mohamed Shokr, Jarrett Weinberger, Diane Levine, and Luis Afonso.
• Department of Internal Medicine, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA. Electronic address: gm0600@wayne.edu.
• Cardiovasc Revasc Med. 2019 Oct 1; 20 (10): 883-886.

BackgroundCardiac support with left ventricular assist devices (LVAD) is a growing field. LVAD are increasingly used for patients with advanced congestive heart failure. Multiple studies have evaluated the outcomes of cardiac support with LVAD in patients with and without diabetes mellitus (DM), yet we still have conflicting results. This study aimed to assess the clinical impact of diabetes mellitus on patients undergoing cardiac support with LVAD.MethodsDiabetic patients who underwent mechanical support with LVAD between 2011 and 2014 were identified in the National Inpatient Sample (NIS) database using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). The primary outcome was the effect of diabetes mellitus on inpatient mortality. Secondary outcomes were the impact of diabetes on other immediate post-LVAD complications and the cost of hospitalization. Multivariable logistic regression models analysis was performed to address potential confounding.ResultsAfter adjusting for patient-level and hospital-level characteristics, diabetic patients who underwent cardiac support with LVAD have no significant increase in in-hospital mortality (OR: 0.79, 95% CI (0.57-1.10), p = 0.166), post-LVAD short-term complications and cost of hospitalization (OR: 0.97, 95% CI (0.93-1.01), p = 0.102).ConclusionCardiac mechanical support with LVAD implantation is feasible and relatively safe in patients with diabetes and stage-D heart failure as a bridge for transplantation or as destination therapy for patients who are not candidates for transplantation. However, further trials and studies using bigger study sample and more comprehensive databases, need to be conducted for a stronger and more valid evidence.Copyright © 2018 Elsevier Inc. All rights reserved.

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