Author:
Moreno Raúl,Díez José-Luis,Diarte José-Antonio,Salinas Pablo,de la Torre Hernández José María,Andres-Cordón Juan F.,Trillo Ramiro,Briales Juan Alonso,Amat-Santos Ignacio,Romaguera Rafael,Díaz José-Francisco,Vaquerizo Beatriz,Ojeda Soledad,Cruz-González Ignacio,Morena-Salas Daniel,Pérez de Prado Armando,Sarnago Fernando,Portero Pilar,Gutierrez-Barrios Alejandro,Alfonso Fernando,Bosch Eduard,Pinar Eduardo,Ruiz-Arroyo José-Ramón,Ruiz-Quevedo Valeriano,Jiménez-Mazuecos Jesús,Lozano Fernando,Rumoroso José-Ramón,Novo Enrique,Irazusta Francisco J.,García del Blanco Bruno,Moreu José,Ballesteros-Pradas Sara M.,Frutos Araceli,Villa Manuel,Alegría-Barrero Eduardo,Lázaro Rosa,Paredes Emilio
Abstract
Abstract
Background
During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes.
Objectives
The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome.
Methods
We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared.
Results
Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables.
Conclusion
Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism
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