Prognosis of diabetic coronary artery bypass graft surgery patients

Moursi, I.; Fakharany, K. Al

doi:10.1016/j.jescts.2017.08.007

Cited by 3 publications

(6 citation statements)

References 17 publications

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“…Baharet al [29] in their retrospective study addressed our inquiry and had similar conclusion to ours. The percentage of overall hospital adverse complications in our study was 30.95% and 36.84% (for group (I) and (II) respectively, results that are similar to the retrospective study reported by Moursiet al [30] who showed 31% in their diabetic group.…”

Section: Discussionsupporting

confidence: 91%

“…Higher levels of HbA1c in our study did not increase the incidence of perioperative myocardial infarction. This is consistent with the results from Iranian center study by Zahra Faritouset al [6], Mona et al [27], Moursi et al [30] and Bahar et al [29]. However, Knapiket al [34] found a different result as they found a significant increase of postoperative myocardial infarction in patients with high levels of HbA1c.…”

Section: Discussionsupporting

confidence: 87%

“…Mean HbA1c% value was 7.5 ± 1.11% (range 7.00-8.6%) for group (I) and 9.3 ± 1.03% (range 8.6-10.3%) for group (II) representing high statistical significance (p<0.01). The study groups included morewomen (62.5%) and cardiovascular risk factors including hypertension and dyslipidemia (with comparable insignificantly different ratios between the two study groups) and these data were in line with those of theliterature [30]. The prevalence of hypertensionin our study was high (66.66%, and 63.16% in group (I) and (II) respectively), comparable to that of the literature (49% to more than 60%) [23] and so does the prevalenceof dyslipidemia (64.29% and 73.68% in group (I) and (II) respectively) as compared to what is settled in the literature (50%-70%) at the time of diagnosis according to Europeanstatistics [24].…”

Section: Discussionsupporting

confidence: 79%

“…The operative mortality in our study was 2.5% (2.38% and 2.63% in group (I) and (II) respectively). It was 3% in the diabetic group and 1% in the non-diabetic group in the study reported by Moursi et al [30] and in the studyreported by Thourani et al [31], the operative mortality was significantly higher in the diabetic group than in the non-diabeticgroup (3.9% vs 1.6%, p<0.0001). However, other studies reported more favorable results in diabetic patients with coronarysurgery.…”

Section: Discussionmentioning

confidence: 75%

“…Razaet al [36] reported survival after CABG among diabetic vs non-diabetic at 1, 5, 10 and 20 years of 94% vs 94%, 80% vs84%, 56% vs66%, and 20% vs32%, respectively. Moursiet al [30], during their follow-up period, reported one death in each group (diabetic and non-diabetic) and acomparable incidence of major cardiovascular events between the two groups (24% and 17%). In our study, we had one-year survival of 95.23% and 94.73% in group (I) and (II) respectively (p>0.05), and had one death in each group with overall mortality 5% (including both operative and one year follow-up).…”

Section: Discussionmentioning

confidence: 99%

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Tracing the Proposed Adverse Effects of Higher Values of Glycosylated Hemoglobin (HbA1c) in Tightly-Controlled Diabetic Patients Undergoing Primary CABG

Elsayed¹,

Eid²

2019

IJCTS

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Objectives:The rising percentage of patients scheduled for primary CABG with HbA1c>8.6% is alarming reflecting higher burden on the patient, operative procedure and the operating surgeon. Although some articles in the literature argue that decompensated diabetes increases mortality and morbidity, other studies are arguing that there is no relation between them. This study aims at tracing the occurrence of the proposed adverse complications after primary CABG operations related to HbA1c values>8.6% in diabetics subjected to tight glycemic control; in a trial to conclude how far the value of HbA1c could be accepted to carry out the surgery safely. Methods:This prospective study included 80 adult diabetic patients who presented with IHD requiring primary CABG. It was conducted between January 2016 and December 2018. Group (I) included 42 patients with HbA1c values<8.6% and group (II) included 38 patients with HbA1c values>8.6%. We compared the following: perioperative MI, low cardiac output syndrome, operative mortality, rhythmic complications, hemorrhagic complications, respiratory complications, cerebrovascular accidents, acute renal failure development, superficial and deep surgical wounds infections, overall hospital complications and overall one-year mortality and survival. Results: Mean HbA1c% value was 7.5 ± 1.11% for group (I) and 9.3 ± 1.03% for group (II). Prior to surgery, the mean FBG level was 136.9±41.7 mg/dl for group (I) and 152.2±27.3 mg/dl for group (II) with tight glycemic control measures. Although group (II) showed higher values in the studied parameters (pre-, intra-and post-operatively), no statistically significant differences appeared between the two subsets of patients regarding the proposed adverse complications. The overall hospital complication rate was 13(30.95%) and 14(36.84%) for group (I) and (II) respectively (p>0.05). In the follow-up period, both groups expressed comparable results with no statistical significance. The overall one-year survival was 95.23% and 94.73% in group (I) and (II) respectively (p>0.05) and the overall mortality was 5% (two deaths from each group) (p>0.05). Conclusion:Although patients with IHD undergoing primary CABG and having decompensated diabetes with HbA1c values>8.6% have more insulted cardiovascular condition, these higher HbA1c values do not add more additional impact on the proposed adverse intra-and postoperative complications as with lower values with the aid of strict (tight) glycemic control measures in the immediate preoperative period.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Tracing the Proposed Adverse Effects of Higher Values of Glycosylated Hemoglobin (HbA1c) in Tightly-Controlled Diabetic Patients Undergoing Primary CABG

Elsayed¹,

Eid²

2019

IJCTS

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To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting

Shah

Rehman²,

Awan³

et al. 2020

Pak J Med Sci

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Objective: To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Methods: This study was conducted at Cardiothoracic Surgery Department, Rehman Medical Institute, Peshawar. Study design was descriptive cross sectional study and the duration of the study was six months. The total sample size was 183 cases using 8.3% frequency of stroke after coronary artery bypass grafting, 95% confidence interval, 4% margin of error, using WHO sample size calculator. Results: In this study mean age was 45 years with SD ± 1.26. Seventy five percent patients were male while 46(25%) females. Six patients (3%) patients had stroke while 177(97%) patients did not have any stroke. Among the six patients who were analyzed, all of them had Diabetes Mellitus and 50% patients had recent AMI, while only one patient had prior history of Atrial Fibrillation. Conclusions: Diabetes Mellitus is an independent risk factor for stroke after CABG surgery. whereas, recent MI is also associated with increased incidence of stroke in post CABG patients. Abbreviations: OPCAB: off-pump coronary artery bypass, CABG: Coronary artery bypass grafting surgery, POAF: Postoperative atrial fibrillation, MI: myocardial infarction, LMS: Left main stem, CPB: cardiopulmonary bypass, AWMI: Anterior wall myocardial infarction, AMI: Acute myocardial Infarction. doi: https://doi.org/10.12669/pjms.37.1.3242 How to cite this:Shah SMA, Ur-Rehman M, Awan NI, Jan A. To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Pak J Med Sci. 2021;37(1):261-266. doi: https://doi.org/10.12669/pjms.37.1.3242 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Сomorbidity of coronary artery disease and its significance in predicting the results of coronary artery bypass grafting

et al. 2022

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The review presents an analysis of the scientific literature on comorbidity of coronary artery disease (CAD) and assessment of its impact on the results of coronary artery bypass grafting (CABG). Arterial hypertension (AH), chronic obstructive pulmonary disease (COPD), metabolic syndrome (MS), and diabetes mellitus (DM) have been shown to be the most common comorbidities in CAD patients. Clinical manifestations of cardiovascular comorbidities also include atrial fibrillation, acute cerebral ischemia, atherosclerosis of carotid and lower limb arteries, and chronic heart failure.Concomitant COPD doubles the risk of postoperative complications after CABG and reduces the 10-year survival rate in patients to 30%. In CAD patients with MS, the risk of postoperative mortality increases by 1.4 times, and the 5-year survival rate decreases by 3 times. Diabetes significantly worsens the long-term survival of patients after CABG and is an independent predictor of acute cardiovascular events after revascularization in the long term. The presence of various comorbidities in CAD patients requires a personalized approach to managing the risks of adverse outcomes after CABG and introduction of modern artificial intelligence (AI) technologies into clinical practice, which significantly increase the accuracy of prognosis.

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Prognosis of diabetic coronary artery bypass graft surgery patients

Cited by 3 publications

References 17 publications

Tracing the Proposed Adverse Effects of Higher Values of Glycosylated Hemoglobin (HbA1c) in Tightly-Controlled Diabetic Patients Undergoing Primary CABG

Tracing the Proposed Adverse Effects of Higher Values of Glycosylated Hemoglobin (HbA1c) in Tightly-Controlled Diabetic Patients Undergoing Primary CABG

To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting

Сomorbidity of coronary artery disease and its significance in predicting the results of coronary artery bypass grafting

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