Significant Increase in the Prevalence of Non-rheumatic Aortic Valve Disease in Patients with Type 2 Diabetes Mellitus

Abstract

Background:Diabetes mellitus (DM) is a major risk for coronary artery disease and hyperlipidemia. The role of Diabetes as an independent risk factor for aortic stenosis or regurgitation has been controversial. The goal of this study was to evaluate any association between DM and non-rheumatic aortic valve disease using a very large database.

Method:We used PTF documents containing discharge diagnosis using ICD-9 codes of inpatient treatment from all Veterans Health Administration Hospitals (VA). The data were stratified using ICD-9 code for DM (n=293,124), a control group with hypertension (HTN) but no DM (n=552,623). The occurrence of non-rheumatic aortic valve disease in DM patients was studied in comparison with the control. We performed multivariate analysis adjusting for coronary artery disease (CAD), congestive heart failure (CHF) , smoking, renal failure, and hyperlipidemia.

Results:Non-rheumatic aortic valve disease diagnosis was present in 7,322 (2.5%) of DM patients vs. 10,906 (2.0%) in the control group. (25% relative increase) Using multivariate analysis, DM remained strongly associated with non-rheumatic aortic valve disease: (odds ratio (OR): 2.23, 95%; confidential interval (CI): 2.16 to 2.30 p<0. 0001).

Conclusion:Type II diabetes mellitus is independently associated with non-rheumatic aortic valve disease. Since women were underrepresented in our study, our results apply only to diabetic men. The cause of this association is not known.

Condense Abstract:The role of Diabetes as an independent risk factor for aortic stenosis or regurgitation has been controversial. We used PTF documents containing discharge diagnosis using ICD-9 codes of inpatient treatment from Veterans Health Administration Hospitals (VA) were analysed.( DM (n=293,124), a control group with hypertension (HTN) but no DM (n=552,623)). The occurrence of non-rheumatic aortic valve disease in DM patients was studied in comparison with the control. Non-rheumatic aortic valve disease diagnosis was present in 7,322 (2.5%) of DM patients vs. 10,906 (2.0%) in the control group. Using multivariate analysis, DM remained strongly associated with non-rheumatic aortic valve disease: (odds ratio (OR): 2.23, 95%; confidential interval (CI): 2.16 to 2.30 p<0. 0001). Since women were underrepresented in our study, our results apply only to diabetic men.

Key words

diabetes mellitus - aortic stenosis - non-rheumatic aortic valve disease - prevalence - aortic regurgitation - valvular heart disease

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