Percutaneous Left Atrial Appendage Closure Among Patients With Diabetes (Insights from a National Database)

Area of Science:

• Cardiology
• Vascular Medicine
• Diabetes Research

Background:

• Atrial fibrillation increases stroke risk, making left atrial appendage closure (LAAC) a key alternative to anticoagulation for high-bleeding-risk patients.
• Diabetes mellitus (DM) is linked to poorer outcomes in cardiac procedures, raising concerns about its impact on LAAC.
• Understanding DM's effect on LAAC outcomes is crucial for patient selection and risk management.

Purpose of the Study:

• To compare procedural and hospital outcomes of left atrial appendage closure (LAAC) in patients with and without diabetes mellitus (DM).
• To assess the safety and efficacy of LAAC in a large cohort of patients with atrial fibrillation and varying DM status.

Main Methods:

• A nationwide retrospective analysis of the Nationwide Inpatient Database (2016-2019).
• Inclusion of patients with atrial fibrillation undergoing left atrial appendage closure (LAAC).
• Comparison of adverse events (in-hospital death, MI, stroke, bleeding, etc.) and length of stay between patients with and without DM.

Main Results:

• The study analyzed 62,220 patients, with 34.9% having diabetes mellitus (DM).
• No significant difference in overall adverse events (9.18% vs. 8.77%) or length of stay was observed between patients with and without DM.
• Patients with DM showed a higher incidence of acute kidney injury (3.75% vs. 1.96%).

Conclusions:

• Diabetes mellitus (DM) is not associated with increased adverse event rates following left atrial appendage closure (LAAC).
• LAAC appears to be a safe and effective stroke prevention strategy for atrial fibrillation patients, irrespective of DM status.
• While overall adverse events are similar, heightened vigilance for acute kidney injury in diabetic patients undergoing LAAC is warranted.