Impact of diabetes in patients waiting for invasive cardiac procedures during COVID-19 pandemic

• Main Authors: Raúl Moreno, José-Luis Díez, José-Antonio Diarte, Pablo Salinas, José María de la Torre Hernández, Juan F. Andres-Cordón, Ramiro Trillo, Juan Alonso Briales, Ignacio Amat-Santos, Rafael Romaguera, José-Francisco Díaz, Beatriz Vaquerizo, Soledad Ojeda, Ignacio Cruz-González, Daniel Morena-Salas, Armando Pérez de Prado, Fernando Sarnago, Pilar Portero, Alejandro Gutierrez-Barrios, Fernando Alfonso, Eduard Bosch, Eduardo Pinar, José-Ramón Ruiz-Arroyo, Valeriano Ruiz-Quevedo, Jesús Jiménez-Mazuecos, Fernando Lozano, José-Ramón Rumoroso, Enrique Novo, Francisco J. Irazusta, Bruno García del Blanco, José Moreu, Sara M. Ballesteros-Pradas, Araceli Frutos, Manuel Villa, Eduardo Alegría-Barrero, Rosa Lázaro, Emilio Paredes
• Format: Article
• Language: English
• Published: BMC 2021-03-01
• Series: Cardiovascular Diabetology
• Subjects: Diabetes; Interventional cardiology; COVID-19; Mortality; Waiting list
• Online Access: https://doi.org/10.1186/s12933-021-01261-2

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.