초록접수 현황
| 15F-083 | 구연 발표 |
New-onset Diabetes Mellitus Negatively Affects Long-term Survival After Heart Transplantation
Ho Jin Kim, Sung-Ho Jung, Joon Bum Kim, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Background : Although new-onset diabetes mellitus (NODM) is known to frequently occur as a complication after heart transplantation, its clinical influence on long-term survival is not well-studied.
Methods : We reviewed the consecutive 391 patients aged 17 years or older (aged 45.4±13.3 years, 283 males) who underwent isolated orthotopic heart transplantation from 1992 through 2013 at the Asan Medical Center. Among them, 88 patients (22.5%) developed NODM postoperatively, and the entire cohort was divided into three groups: No-diabetes group (n=257), Preexisting diabetes group (n=46), and New-onset diabetes group (n=88). The early and late clinical outcomes were compared between the three groups. The correlation between NODM and long-term survival was analyzed using Cox proportional-hazard model where NODM was considered as a time-dependent variable.
Results : Early mortality occurred in 8 patients (2.0%). During a median follow-up period of 65.2 months (interquartile range, 33.8-114.8), 83 patients (21.2%) died. On Kaplan-Meier analysis, the NODM patients showed a significantly inferior long-term survival compared with those in the No-diabetes group (P=0.003), but there was no significant difference in the overall survival rate between the Preexisting diabetes and New-onset diabetes group (P=0.451). On further analysis, new-onset DM were associated with a significantly increased risk in all-cause death (hazard radio [HR], 2.33; 95% confidence interval [CI], 1.43-3.80; P=0.001).
Conclusion : New-onset DM confers a negative impact to long-term survival after heart transplantation. These findings indicate that the close surveillance of new-onset DM and meticulous postoperative DM control may improve the long-term survival in this cohort.
Methods : We reviewed the consecutive 391 patients aged 17 years or older (aged 45.4±13.3 years, 283 males) who underwent isolated orthotopic heart transplantation from 1992 through 2013 at the Asan Medical Center. Among them, 88 patients (22.5%) developed NODM postoperatively, and the entire cohort was divided into three groups: No-diabetes group (n=257), Preexisting diabetes group (n=46), and New-onset diabetes group (n=88). The early and late clinical outcomes were compared between the three groups. The correlation between NODM and long-term survival was analyzed using Cox proportional-hazard model where NODM was considered as a time-dependent variable.
Results : Early mortality occurred in 8 patients (2.0%). During a median follow-up period of 65.2 months (interquartile range, 33.8-114.8), 83 patients (21.2%) died. On Kaplan-Meier analysis, the NODM patients showed a significantly inferior long-term survival compared with those in the No-diabetes group (P=0.003), but there was no significant difference in the overall survival rate between the Preexisting diabetes and New-onset diabetes group (P=0.451). On further analysis, new-onset DM were associated with a significantly increased risk in all-cause death (hazard radio [HR], 2.33; 95% confidence interval [CI], 1.43-3.80; P=0.001).
Conclusion : New-onset DM confers a negative impact to long-term survival after heart transplantation. These findings indicate that the close surveillance of new-onset DM and meticulous postoperative DM control may improve the long-term survival in this cohort.
책임저자: Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
연락처 : Ho Jin Kim, Tel: 010-4348-0927 , E-mail : rhonin.hojin@gmail.com
