Results:

A total of 83 patients met inclusion criteria. The mean age was 61.3 ± 11.8 years, and the majority of study patients was male, white, and had a body mass index of ≥30 kg/m2. Ischemic cardiomyopathy was the most common etiology of HF, and 89% of patients were New York Heart Association Functional Class IV. The mean pre-LVAD A1c was 7.46 ± 1.5%, which significantly decreased to 6.21 ± 1.5% (p < 0.001) based on the first available postoperative A1c after LVAD implantation (median of 4.8 months). This improvement in A1c remained significant throughout the 24-month follow-up period. At the end of the 24 months, insulin requirements decreased by nearly 23 units from baseline, and 12 of the 42 patients receiving insulin monotherapy discontinued insulin during the follow-up period. Additionally, over half of those on noninsulin antidiabetic medications discontinued therapy by study end. A prespecified regression analysis showed that only preoperative A1c predicted change in A1c (R2 = 0.33).