Chest
Clinical InvestigationsSURGERYThe Influence of Type 2 Diabetes Mellitus in Patients Undergoing Coronary Artery Bypass Graft Surgery: An 8-Year Prospective Cohort Study
Section snippets
Materials and Methods
We conducted a prospective hospitalization cohort study. Patients entered the cohort on admission to the hospital and exited the cohort 30 days after hospital discharge. The study population consisted of patients undergoing CABG surgery by the Cardiovascular Thoracic Surgery Group, located in Cincinnati, OH. The inclusion criteria included CAGB surgery between October 1, 1993, and July 1, 2002, and age > 18 years. The exclusion criteria included any other surgery performed simultaneously with
Results
During the study period, 9,551 patients had CABG surgery. A total of 6,711 patients met our inclusion criteria and were available for our analysis. This consisted of 2,178 patients with type 2 diabetes and 4,533 nondiabetic patients. Among the diabetic patients, diabetes was controlled by diet in 247 patients and by oral medication in 1,207 patients, and 724 patients were insulin-dependent.
Univariate analysis comparing diabetic status with the three demographic variables and the 13
Discussion
In this study, we determined the impact of diabetes mellitus on morbidity and total operative mortality after coronary bypass surgery. This study has the advantage of being prospective and including a relatively high prevalence of diabetic patients (32%). Univariate analysis revealed that the diabetic patients had more cardiovascular comorbidities at the time of surgery compared to nondiabetic patients, even though there was no significant difference in age. This is similar to the findings of
Conclusion
Patients with type 2 diabetes who are undergoing CABG surgery experience significantly more total operative mortality compared to nondiabetic patients, even after controlling for multiple variables. There was no difference between diabetic patients and nondiabetic patients for 12 morbidity outcomes.
ACKNOWLEDGMENT
The authors would like to acknowledge the assistance of Dr. Loren F. Hiratzka in the collection and quality control of the data for this publication.
References (19)
Diabetes and coronary heart disease
Endocrinol Metab Clin North Am
(2001)- et al.
Northern New England Study Group: survival of patients with diabetes and multivessel coronary artery disease after surgical or percutaneous coronary revascularization: results of a large regional prospective study
J Am Coll Cardiol
(2001) - et al.
Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting
Ann Thorac Surg
(1999) - et al.
Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery
J Am Coll Cardiol
(2002) - et al.
Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting
Ann Thorac Surg
(2002) - et al.
The Prospective Cardiovascular Munster Study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart disease
Am Heart J
(1988) - et al.
Coronary artery bypass performed without the use of cardiopulmonary bypass is associated with reduced cerebral microemboli and improved clinical results
Chest
(2001) - et al.
Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction
N Engl J Med
(1998) Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI)
Circulation
(1997)
Cited by (44)
Incidence of cardiovascular events and vascular interventions in patients with type 2 diabetes
2017, International Journal of CardiologyCitation Excerpt :Diabetes is associated with an increased risk of atherosclerotic cardiovascular complications such as MI, stroke, renal disease and peripheral artery disease [2,3]. For example, T2DM is associated with a more than two-fold increase in the rate of MI and all-cause mortality [4], while having a poorer outcome after coronary revascularization [5–8] and bypass grafting [9–10]. This increased risk associated with T2DM is not limited to coronary artery disease (CAD) but extends to both ischemic and haemorrhagic stroke [11], including a poorer functional outcome and cognitive recovery afterwards [12–14].
Cyclooxygenase 2 contributes to bradykinin-induced microvascular responses in peripheral arterioles after cardiopulmonary bypass
2017, Journal of Surgical ResearchDiabetic hearts have lower basal urocortin levels that fail to increase after cardioplegic arrest: Association with increased apoptosis and postsurgical cardiac dysfunction
2014, Journal of Thoracic and Cardiovascular SurgeryInfluence of diabetes mellitus on long-term clinical and economic outcomes after coronary artery bypass grafting
2014, Annals of Thoracic SurgeryComparison of nonculprit coronary plaque characteristics between patients with and without diabetes: A 3-vessel optical coherence tomography study
2012, JACC: Cardiovascular Interventions