Coronary artery bypass grafting in patients with concomitant diabetes mellitus: Perioperative profile and early postoperative complications

Abstract

Background and Aims : To evaluate perioperative profile and early postoperative complications (EPOCs) in patients with stable coronary artery disease (SCAD) and diabetes mellitus (DM), undergoing isolated coronary artery bypass grafting (CABG).Methods: We enrolled 600 consecutive SCAD patients (mean age 61±9 years, 511 (85,2%) males), undergoing isolated CABG. DM type 2 was diagnosed in 212 (35,3%) patients. We analyzed perioperative clinical and instrumental data, and EPOCs cases. Totally, EPOCs were registered in 112 (18,7%) patients.Results: The DM group, as compared to SCAD patients without DM, was characterized by the higher prevalence of females (21,7% vs. 11,1%, respectively; p<0,001) and moderate-to-severe obesity cases (15,6% vs. 4,9%, respectively; p<0,001), as well as the higher frequency of patients with 3-vessel disease (87,7% vs. 73,7%, respectively; p<0,001). EPOCs were more prevalent in DM group (vs. no-DM: 32,1% and 11,3%, respectively; p<0,001), namely due to the higher frequency of acute kidney injury, acute heart failure and acute cerebrovascular events cases. Consequently, the perioperative profile of DM patients, as opposed to no-DM patients, included longer inotropic support and intensive care.Conclusions: The concomitant DM worsens coronary atherosclerosis burden and perioperative profile in patients undergoing isolated CABG, namely by the higher frequency of EPOCs, requiring longer intensive care. Further investigations aimed at the EPOCs risk reduction are needed for SCAD patients with concomitant DM, undergoing surgical revascularization. Background and Aims : To evaluate perioperative profile and early postoperative complications (EPOCs) in patients with stable coronary artery disease (SCAD) and diabetes mellitus (DM), undergoing isolated coronary artery bypass grafting (CABG). Methods: We enrolled 600 consecutive SCAD patients (mean age 61±9 years, 511 (85,2%) males), undergoing isolated CABG. DM type 2 was diagnosed in 212 (35,3%) patients. We analyzed perioperative clinical and instrumental data, and EPOCs cases. Totally, EPOCs were registered in 112 (18,7%) patients. Results: The DM group, as compared to SCAD patients without DM, was characterized by the higher prevalence of females (21,7% vs. 11,1%, respectively; p<0,001) and moderate-to-severe obesity cases (15,6% vs. 4,9%, respectively; p<0,001), as well as the higher frequency of patients with 3-vessel disease (87,7% vs. 73,7%, respectively; p<0,001). EPOCs were more prevalent in DM group (vs. no-DM: 32,1% and 11,3%, respectively; p<0,001), namely due to the higher frequency of acute kidney injury, acute heart failure and acute cerebrovascular events cases. Consequently, the perioperative profile of DM patients, as opposed to no-DM patients, included longer inotropic support and intensive care. Conclusions: The concomitant DM worsens coronary atherosclerosis burden and perioperative profile in patients undergoing isolated CABG, namely by the higher frequency of EPOCs, requiring longer intensive care. Further investigations aimed at the EPOCs risk reduction are needed for SCAD patients with concomitant DM, undergoing surgical revascularization.