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

Background: 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. Methods: 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. Results: 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. Conclusion: 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.