Carotid disease in diabetic patients undergoing coronary artery bypass grafting

Muhammad Shahid1, Abdul Rehman Abid, Muhammad Ashraf Dar

  • 1Punjab Institute of Cardiology, Lahore, Pakistan. drshahid68@hotmail.com

Insights

Diabetic patients undergoing coronary artery bypass grafting have a higher prevalence of significant carotid artery disease and diffuse coronary artery disease compared to non-diabetics. This highlights the importance of assessing carotid health in diabetic patients before surgery.

Area of Science:

  • Cardiovascular Surgery
  • Diabetology
  • Vascular Medicine

Background:

  • Diabetes mellitus is a significant risk factor for cardiovascular disease.
  • Coronary artery bypass grafting (CABG) is a common procedure for severe coronary artery disease.
  • Carotid artery disease can increase the risk of stroke during or after CABG.

Purpose of the Study:

  • To compare the severity of carotid artery disease in diabetic versus non-diabetic patients undergoing CABG.
  • To investigate the association between diabetes and coronary artery disease patterns in patients undergoing CABG.

Main Methods:

  • A prospective study of 379 patients undergoing elective CABG from January to June 2008.
  • Preoperative duplex scanning to assess carotid stenoses.
  • Patients divided into diabetic (n=156) and non-diabetic (n=223) groups.

Main Results:

  • Diabetic patients showed a higher incidence of left main stem stenosis (37.8% vs 20.2%, p<0.0001).
  • Significant carotid artery stenosis was more prevalent in diabetics (19.2% vs 9%, p<0.004).
  • >70% carotid stenosis was also more frequent in diabetics (8.3% vs 3.1%, p<0.025).

Conclusions:

  • Diabetes mellitus is associated with more diffuse coronary artery disease.
  • Diabetic patients undergoing CABG have a significantly higher prevalence of significant carotid artery disease.
  • Preoperative screening for carotid artery disease is crucial in diabetic patients scheduled for CABG.
Abstract

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