Abstract 16391: No Need to “Sugar Coat It”: Baseline Diabetic Status Does Not Impact Outcomes in Destination Therapy Patients Implanted With the HeartwareTM HVADTM in the ENDURANCE and ENDURANCE Supplemental Trials

IntroductionPrevious studies have demonstrated that patients with diabetes mellitus (DM) who receive a left ventricular assist device (LVAD) for the treatment of advanced heart failure have increased mortality and adverse events despite improved glycemic control. These studies have predominantly examined patients with axial-flow LVADs. We hypothesized that DM patients receiving a centrifugal flow (CF) LVAD would experience a similar increase in mortality and adverse events.MethodsWe performed a post-hoc analysis of patients supported by a CF LVAD (Heartware HVAD System) from the ENDURANCE and ENDURANCE Supplemental trials (n=604) to evaluate their adverse event rate and 2-year survival. Patients were separated into 3 groupsthose without DM (n=320), those with insulin-dependent DM (n=170), and those with non-insulin-dependent DM (n=114).ResultsAt baseline, patients with DM were more likely to have worse renal function, ischemic cardiomyopathy, and hypertension. Despite these differences, there were no significant differences in common adverse LVAD events (bleeding, stroke, infection, or thrombosis) (Table 1) or 2-year survival (Figure 1).ConclusionsDiabetic patients implanted with the HVAD system had similar incidences of adverse events and 2-year survival as non-diabetic patients despite significant differences in baseline risk factors. While the mechanism is unclear, this finding may have implications for patient-specific device selection and warrants further study.