Diabetes mellitus (DM) is a major risk for cardiovascular disease and mortality. There is a recent study that found DM was associated with aortic stenosis in univariate but not in multivariate analysis. The goal of this study was to evaluate any association between DM and non-rheumatic aortic valve stenosis or regurgitation using ICD-9 codes in a very large database.
We used PTF documents containing discharge diagnoses using ICD-9 codes of inpatient treatment from all Veterans Health Administration hospitals. The data were stratified using ICD-9 code for DM (n=293,124), and a control group with hypertension (HTN) but no DM (n=552,623), and the ICD-9 code for non-rheumatic aortic valve disorder(424.1). We performed multivariate analysis adjusting for coronary artery disease, congestive heart failure, smoking and hyperlipidemia. Continuous and binary variables were analyzed using c2 and Fisher’s Exact tests.
Non-rheumatic aortic valve disease diagnosis was present in 7,322 (2.5%) of DM patients vs. 10906 (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. 000).
Type II diabetes mellitus is independently associated with non-rheumatic aortic valve disorders (regurgitation and stenosis) suggesting the direct negative effect of DM on aortic valve structure.
Patient with DM may need close follow-up for the occurence of aortic valve stenosis or regurgitation.
Mohammad-Reza Movahed, None.