Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China

Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods...

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Autores principales:	Yuan-Feng Liang, Feier Song, Huixia Liu, Jian Liu, Yu-Yuan Zhang, Wei-Dong Lin, Hong-Tao Liao, Hui-Ming Guo, Gary Tse, Fang-Zhou Liu, Zhanyi Lin
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/0342e801ba8b44db850734289b1f6e38
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spelling	oai:doaj.org-article:0342e801ba8b44db850734289b1f6e382021-11-08T02:37:21ZClinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China2090-059710.1155/2021/2558639https://doaj.org/article/0342e801ba8b44db850734289b1f6e382021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/2558639https://doaj.org/toc/2090-0597Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods. This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization. Results. Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group (n = 377), the DM group (n = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, P=0.001), heart failure rehospitalization (37.4% vs. 20.7%, P<0.001), and MACCEs (60.0% vs. 35.8%, P<0.001). After adjustment of confounders by the multivariable cox regression, DM appeared as an independent predictor for MACCEs (adjusted hazard ratio, aHR: 1.88; 95% confidence interval 1.42–2.48; P<0.001). In the subgroup analysis of VHD etiology and functional style, conversely, DM was a protective factor for MACCEs in the patients with rheumatic VHD compared with those without rheumatic VHD (aHR: 0.43 vs. 2.27, P=0.004). Conclusions. DM was an independent predictor for ischemic stroke and heart failure rehospitalization in elderly VHD patients undergoing conservative treatment.Yuan-Feng LiangFeier SongHuixia LiuJian LiuYu-Yuan ZhangWei-Dong LinHong-Tao LiaoHui-Ming GuoGary TseFang-Zhou LiuZhanyi LinHindawi LimitedarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiology Research and Practice, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Yuan-Feng Liang Feier Song Huixia Liu Jian Liu Yu-Yuan Zhang Wei-Dong Lin Hong-Tao Liao Hui-Ming Guo Gary Tse Fang-Zhou Liu Zhanyi Lin Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
description	Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods. This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization. Results. Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group (n = 377), the DM group (n = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, P=0.001), heart failure rehospitalization (37.4% vs. 20.7%, P<0.001), and MACCEs (60.0% vs. 35.8%, P<0.001). After adjustment of confounders by the multivariable cox regression, DM appeared as an independent predictor for MACCEs (adjusted hazard ratio, aHR: 1.88; 95% confidence interval 1.42–2.48; P<0.001). In the subgroup analysis of VHD etiology and functional style, conversely, DM was a protective factor for MACCEs in the patients with rheumatic VHD compared with those without rheumatic VHD (aHR: 0.43 vs. 2.27, P=0.004). Conclusions. DM was an independent predictor for ischemic stroke and heart failure rehospitalization in elderly VHD patients undergoing conservative treatment.
format	article
author	Yuan-Feng Liang Feier Song Huixia Liu Jian Liu Yu-Yuan Zhang Wei-Dong Lin Hong-Tao Liao Hui-Ming Guo Gary Tse Fang-Zhou Liu Zhanyi Lin
author_facet	Yuan-Feng Liang Feier Song Huixia Liu Jian Liu Yu-Yuan Zhang Wei-Dong Lin Hong-Tao Liao Hui-Ming Guo Gary Tse Fang-Zhou Liu Zhanyi Lin
author_sort	Yuan-Feng Liang
title	Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
title_short	Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
title_full	Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
title_fullStr	Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
title_full_unstemmed	Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China
title_sort	clinical characteristics and long-term prognosis of elderly valvular heart disease patients with diabetes mellitus: five-year experience from a single-center study of southern china
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/0342e801ba8b44db850734289b1f6e38
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Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China

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