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[Risk Factors of Cardiovascular Complications After Beating-Heart Coronary Artery Bypass Grafting in Patients With

S Y Borodashkina1,2, K V Protasov1,2, V A Podkamennyi1,2

  • 1Irkutsk Regional Clinical Hospital, Irkutsk, Russia.

Kardiologiia
|August 2, 2017
PubMed

Insights

Peripheral artery disease, glucose variability, and switching to insulin are key risk factors for early cardiovascular complications after off-pump coronary artery bypass grafting in patients with diabetes.

Area of Science:

  • Cardiology
  • Diabetology
  • Vascular Surgery

Background:

  • Ischemic heart disease (IHD) and type 2 diabetes (D2) are significant risk factors for cardiovascular complications.
  • Off-pump coronary artery bypass grafting (CABG) is a common revascularization strategy for these patients.
  • Early cardiovascular complications (CVC) after CABG can lead to adverse outcomes.

Purpose of the Study:

  • To identify risk factors for early cardiovascular complications (CVC) following off-pump coronary artery bypass grafting (CABG).
  • To analyze the association between preoperative patient characteristics and postoperative CVC in patients with IHD and D2.

Main Methods:

  • A case-control study included 188 patients with IHD and D2 undergoing off-pump CABG.
  • Cardiovascular complications (myocardial infarction, stroke, atrial fibrillation) within 7 days post-surgery were analyzed.
  • Multiple stepwise logistic regression was used to determine predictors of CVC.

Main Results:

  • Cardiovascular complications occurred in 47 patients (25%).
  • Higher Canadian Cardiovascular Society angina class, EuroSCORE II, lower ejection fraction, and reduced glomerular filtration rate were observed in patients with CVC.
  • Peripheral artery disease, diurnal glucose variability, and preoperative switch to insulin were identified as significant predictors of CVC.

Conclusions:

  • Peripheral artery disease, significant diurnal serum glucose variability, and conversion from oral hypoglycemic agents to insulin are independent predictors of early CVC after off-pump CABG in diabetic patients.
  • These findings highlight the importance of optimizing glycemic control and assessing vascular disease severity preoperatively.
Abstract

Keywords:
CABGcardiovascular complicationsdiabetesischemic heart diseaserisk factors

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