Advanced Symptoms in Diabetics Mitigates Early Benefits of Coronary Artery Bypass Grafting: Analysis of Over 10,000 Patients  

作　　者：Tiffany Agbobu Dumbor L. Ngaage Tiffany Agbobu;Dumbor L. Ngaage(Hull York Medical School, University of Hull, Kingston upon Hull, UK;Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Kingston upon Hull, UK)

机构地区：[1]Hull York Medical School, University of Hull, Kingston upon Hull, UK [2]Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Kingston upon Hull, UK

出　　处：《World Journal of Cardiovascular Surgery》2025年第2期59-68,共10页心血管外科国际期刊(英文)

摘　　要：Objectives: Coronary artery bypass grafting (CABG) is the preferred revascularisation option for diabetics with multivessel coronary artery disease, in current guideline recommendations. Not infrequently, coronary artery disease causes minimal symptoms in diabetic patients, so they present late for surgery and this could have implications for clinical outcomes. We sought to examine differences in symptom severity between diabetics and non-diabetics at presentation for CABG, and the impact on in-hospital outcomes. Methods: We retrieved prospectively collected data for all patients who had CABG between January 2000 and December 2022. Perioperative variables were compared between diabetic and non-diabetics. The association between in-hospital major adverse cardiac and cerebrovascular events (MACCE) and perioperative variables was determined using multivariate analysis. Results: Of 10,834 patients, diabetics constituted 24.8% (n = 2687) with mean age 66.4 ± 8.7 years compared to non-diabetics 65.9 ± 9.4, p = 0.02. More diabetics (p Conclusions: Diabetics more often presented for non-elective CABG with advanced symptoms, impaired left ventricular function, prior myocardial infarction and coronary stenting. Advanced symptoms contributed to higher MACCE rates in diabetics. Diabetic patients should be referred early for surgery.Objectives: Coronary artery bypass grafting (CABG) is the preferred revascularisation option for diabetics with multivessel coronary artery disease, in current guideline recommendations. Not infrequently, coronary artery disease causes minimal symptoms in diabetic patients, so they present late for surgery and this could have implications for clinical outcomes. We sought to examine differences in symptom severity between diabetics and non-diabetics at presentation for CABG, and the impact on in-hospital outcomes. Methods: We retrieved prospectively collected data for all patients who had CABG between January 2000 and December 2022. Perioperative variables were compared between diabetic and non-diabetics. The association between in-hospital major adverse cardiac and cerebrovascular events (MACCE) and perioperative variables was determined using multivariate analysis. Results: Of 10,834 patients, diabetics constituted 24.8% (n = 2687) with mean age 66.4 ± 8.7 years compared to non-diabetics 65.9 ± 9.4, p = 0.02. More diabetics (p Conclusions: Diabetics more often presented for non-elective CABG with advanced symptoms, impaired left ventricular function, prior myocardial infarction and coronary stenting. Advanced symptoms contributed to higher MACCE rates in diabetics. Diabetic patients should be referred early for surgery.

关 键 词：Coronary Artery Disease Diabetes Mellitus Advanced Cardiac Symptoms Coronary Artery Bypass Grafting Major Adverse Cardiac and Cerebrovascular Event 

分 类 号：R54[医药卫生—心血管疾病]