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Diabetes complications and adverse health outcomes after coronary revascularization

Bola F Ekezue1, S B Laditka1, J N Laditka1

  • 1Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.

Diabetes Research and Clinical Practice
|January 21, 2014
PubMed

Insights

Patients with diabetes complications undergoing heart revascularization (coronary artery bypass graft or percutaneous coronary intervention) face higher risks of in-hospital death and kidney failure.

Area of Science:

  • Cardiology
  • Endocrinology
  • Health Services Research

Background:

  • Diabetes mellitus is a prevalent condition associated with microvascular and macrovascular complications.
  • Patients with diabetes often require revascularization procedures like coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for coronary artery disease.
  • The impact of diabetes complications on outcomes after these procedures is a critical area of investigation.

Purpose of the Study:

  • To investigate the association between diabetes complications and health outcomes in patients undergoing CABG or PCI.
  • To compare outcomes between diabetic patients with and without diabetes complications.

Main Methods:

  • Retrospective analysis of Nationwide Inpatient Sample data from 2007, including 61,566 diabetic patients aged 45+ undergoing CABG or PCI.
  • Propensity score-adjusted logistic regression was employed to control for confounding factors.

Main Results:

  • 21.2% of the weighted sample had diabetes complications, more common in older, Black, Hispanic, and sicker patients.
  • Diabetes complications were linked to significantly higher unadjusted and adjusted in-hospital mortality and renal failure.
  • Percutaneous coronary intervention (PCI) showed an increased risk of postoperative renal failure compared to CABG specifically for patients with diabetes complications.

Conclusions:

  • Diabetes complications significantly elevate the risks of in-hospital mortality and renal failure following coronary revascularization.
  • These elevated risks persist regardless of whether patients undergo CABG or PCI.
  • Identifying and managing diabetes complications is crucial for improving outcomes in patients undergoing cardiac procedures.
Abstract

Keywords:
Administrative dataCoronary by-pass surgeryDiabetes complicationsPercutaneous coronary interventionPropensity score

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