# Impact of diabetes mellitus type-2 on the outcomes following mitral transcatheter edge-to-edge repair (TEER): A meta-analysis

## TL;DR

This study finds that diabetes increases the risk of certain complications after a heart procedure called Mitral TEER, though mortality rates are similar between diabetic and non-diabetic patients.

## Contribution

The study provides a meta-analysis showing that diabetes is linked to higher 30-day adverse events and hospitalizations after Mitral TEER, despite similar mortality rates.

## Key findings

- Diabetic patients had a 50% higher risk of 30-day MACCE compared to non-diabetic patients.
- Diabetic patients had a 36% higher risk of recurrent hospitalizations within 30 days.
- No significant difference in 30-day or in-hospital mortality was found between diabetic and non-diabetic patients.

## Abstract

Diabetes mellitus (DM) has been linked to unfavorable outcomes in patients undergoing Mitral Transcatheter Edge-to-Edge Repair (TEER). Nevertheless, the literature contains conflicting data. This meta-analysis aimed to assess the impact of DM on outcomes following Mitral TEER.

We searched PubMed, Scopus, and Medline for studies reporting outcomes following mitral TEER in diabetic and non-diabetic patients. Using a random-effects model, we determined the pooled odds ratio (OR) for clinical outcomes in patients who underwent Mitral TEER, regardless of their diabetes status.

We included four studies with 2130 patients. DM was present in 31 % of the population, with a mean age of 73.9 (±8.2) years, 50.2 % of males, and 30 % of the population being obese. Patients with DM were more likely to be obese compared to patients without DM. In this meta-analysis, individuals with DM exhibited a higher 30-day MACCE (OR: 1.50, 95 % CI: 1.08–2.09, p = 0.02) and all-cause recurrent hospitalizations (OR: 1.36, 95 % CI: 1.07–1.72, p = 0.01) compared to those without diabetes. However, the difference in 30-day all-cause mortality (OR: 1.20, 95 % CI: 0.92–1.56, p = 0.19) and in-hospital all-cause mortality (OR: 0.92, 95 % CI: 0.51–1.67, p = 0.78) was not statistically significant between the two groups.

DM is associated with an increased risk of 30-day MACCE and recurrent hospitalizations following Mitral TEER. Consequently, DM should be regarded as a predictor of adverse outcomes. Future, well-designed prospective randomized trials are necessary to evaluate the mid-term impact of DM on MACCE.

•Diabetes Mellitus (DM) is associated with increased risks of 30-day Major adverse cardiac and cerebrovascular events and recurrent hospitalizations in patients undergoing Mitral-TEER.•The procedure duration was shorter among the individuals with diabetes than those without diabetes, and the number of implanted clips was comparable in both groups at 1.4 ± 0.6.•No significant difference in in-hospital and 30-day mortality was noted between the groups•We have not seen any significant difference in the mid-term mortality and MACCE between both the groups•Patients with diabetes mellitus had a higher prevalence of comorbidities when compared to patients without diabetes and also higher surgical risk candidates.

Diabetes Mellitus (DM) is associated with increased risks of 30-day Major adverse cardiac and cerebrovascular events and recurrent hospitalizations in patients undergoing Mitral-TEER.

The procedure duration was shorter among the individuals with diabetes than those without diabetes, and the number of implanted clips was comparable in both groups at 1.4 ± 0.6.

No significant difference in in-hospital and 30-day mortality was noted between the groups

We have not seen any significant difference in the mid-term mortality and MACCE between both the groups

Patients with diabetes mellitus had a higher prevalence of comorbidities when compared to patients without diabetes and also higher surgical risk candidates.