Abstract 1534: Diabetes Mellitus Is An Independent Predictor Of Mortality In Defibrillator Recipients
Background: Previous studies have shown an increased morbidity and mortality risk in patients with diabetes mellitus (DM) undergoing percutaneous coronary interventions and cardiac surgery. However, the impact of DM on mortality in patients with implantable cardioverter defibrillators (ICDs) is unknown.
Aim: to investigate whether DM was associated with increased mortality risk in patients with ICDs
Methods: A retrospective review of all ICD patients followed within a consecutive 2.5 year period was performed. Baseline characteristics and mortality data were compared between DM and non-DM patients. Mann Whitney test was used to analyze the differences between the means, and multivariate logistic regression analysis was performed to identify independent predictors of mortality.
Results: A total of 336 patients with ICDs (including 141 patients with DM and 195 without DM) were studied. The mean age was 66.8 ± 9.6 years in the overall population, with no significant difference in baseline characteristics between the 2 groups, except for beta-blocker therapy, creatinine, and estimated glomerular infiltration rate (EGFR). Use of beta-blockers was greater in the non-DM group (92.8% vs 84.4%, p=0.02). Renal function was worse in the DM group, as documented by a higher serum creatinine (1.6 ± 0.8 mg/dl in DM vs 1.38 ± 0.74 mg/dl in non-DM, p = 0.003) and a lower EGFR (55.9 ± 22.9 ml/min/1.73m2 vs 63.5 ± 19.9 ml/min/1.73m2, p=0.0005). Although the incidence of VT was not significantly different between the two groups, there was a significantly higher mortality in the DM group (27.7% vs 11.3% in non-DM, p=0.0002). On multivariate stepwise logistic regression analysis, DM was a significant independent predictor of mortality (OR 2.38, 95% CI 1.3– 4.36, p =0.005).
Conclusion: DM is an independent predictor of mortality in ICD patients. Prevention of DM, as well as early diagnosis and intervention, should be emphasized in order to reduce the growing epidemic of type 2 DM and its associated complications.