Original articleAdult cardiacInfluence of Diabetes Mellitus on Long-Term Survival in Systematic Off-Pump Coronary Artery Bypass Surgery
Section snippets
Study Design
This is a retrospective analysis of prospectively gathered data over a 10-year period (mean follow-up, 66 ± 28 months) of patients systematically undergoing OPCABG surgery by a single surgeon (R.C.) at the Montreal Heart Institute. From September 1996 to March 2004, 1,000 OPCABG operations were performed, representing 95% of all cases during the same time frame. Follow-up of the patients was 100% completed at 12 months. After this period, 3% of the patients were lost to follow-up. The general
Results
There were 278 diabetic patients (28%), and of them, 30 (10.2%) were on insulin therapy.
Comment
Previous studies have reported conflicting results regarding the adverse effect of DM on surgical outcomes after CABG [11, 12, 13, 14, 15, 16]. These equivocal data may be due to several factors, such as the extent of coronary artery disease, adequacy of DM control, strategy of conduit selection, and surgical techniques including cardiopulmonary bypass [13, 16, 17, 18, 19, 20, 21, 22].
The short-term safety and effectiveness of OPCABG have been clearly established by many groups with results
References (44)
- et al.
Coronary heart disease in patients with diabetesPart I: recent advances in prevention and noninvasive management
J Am Coll Cardiol
(2007) Lipids, diabetes, and coronary heart disease: insights from the Framingham Study
Am Heart J
(1985)- et al.
Coronary heart disease in patients with diabetesPart II: recent advances in coronary revascularization
J Am Coll Cardiol
(2007) - et al.
Coronary revascularization without cardiopulmonary bypass versus the conventional approach in high-risk patients
Ann Thorac Surg
(2005) - et al.
Early stenosis after coronary artery snaring during off-pump coronary artery bypass in a patient with diabetes
J Thorac Cardiovasc Surg
(2001) - et al.
Routine use of the left internal mammary artery graft in the elderly
Ann Thorac Surg
(1990) - et al.
Effects of coronary artery bypass grafting using internal thoracic arteries for diabetic patients
J Am Coll Cardiol
(1999) - et al.
Favorable results of coronary artery bypass grafting in patients older than 75 years
J Thorac Cardiovasc Surg
(1990) - et al.
Single versus bilateral internal mammary artery graft: 10-year outcome analysis
Ann Thorac Surg
(1997) - et al.
Comparison of factors associated with 30-day mortality after coronary artery bypass grafting in patients with versus without diabetes mellitus
Am J Cardiol
(1998)
Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting
J Thorac Cardiovasc Surg
Two internal thoracic artery grafts are better than one
J Thorac Cardiovasc Surg
On-pump versus off-pump coronary artery bypass grafting in diabetic patients: a propensity score analysis
Ann Thorac Surg
Influence of diabetes on mortality and morbidity: off-pump coronary artery bypass grafting versus coronary artery bypass grafting with cardiopulmonary bypass
Ann Thorac Surg
Effects of diabetes on early and late survival after isolated first coronary bypass surgery in multivessel disease
J Thorac Cardiovasc Surg
Early postoperative outcome and medium-term survival in 540 diabetic and 2,239 nondiabetic patients undergoing coronary artery bypass grafting
Ann Thorac Surg
Coronary artery bypass grafting in type II diabetic patients: a comparison between insulin-dependent and non-insulin-dependent patients at short- and mid-term follow-up
Ann Thorac Surg
The effect of diabetes mellitus on patients undergoing coronary surgery: a risk-adjusted analysis
J Thorac Cardiovasc Surg
Effect of risk-adjusted diabetes on mortality and morbidity after coronary artery bypass surgery
Ann Thorac Surg
Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting
Ann Thorac Surg
Long-term survival of more than 2,000 patients after coronary artery bypass grafting
Am J Cardiol
Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery
J Am Coll Cardiol
Cited by (27)
Clinical outcomes of off-pump coronary artery bypass graft in patients with diabetes and non-diabetics: A systematic review and meta-analysis
2022, Diabetes and Metabolic Syndrome: Clinical Research and ReviewsCitation Excerpt :This meta-analysis demonstrated that cardiovascular complications were higher in patients with diabetes. It is believed that these patients are more likely to have more complications [26] and DM results in a significant increase in the rate of atherogenesis, lipid disorders, and myocardial problems, which can cause severe cardiovascular events [27]. One of these cardiovascular complications was atrial fibrillation which is one of the most common types of arrhythmia after cardiac surgery.
Impact of body constitution on complications following pancreaticoduodenectomy: A retrospective cohort study
2017, International Journal of SurgeryCitation Excerpt :Our results are coherent with previous studies [9,10,12,27] and conclude that overweight and large patients are at risk of complications following PD. Although no correlation between diabetes and complications was shown in this study, diabetes is a well-known risk factor of postoperative medical and surgical complications [28–30]. The risk of developing POPF grades B and C was significantly increased among overweight and large patients in all of the three anthropometric subgroups and the risk was up to five times higher in the obese BMI-subgroup.
Contemporary outcomes of coronary artery bypass grafting among patients with insulin-treated and non-insulin-treated diabetes
2015, Annals of Thoracic SurgeryOutcomes of coronary revascularization (percutaneous or bypass) in patients with diabetes mellitus and multivessel coronary disease
2012, American Journal of CardiologyRole of CABG in the management of obstructive coronary arterial disease in patients with diabetes mellitus
2012, Current Opinion in Pharmacology