Influence of Body Mass Index and Glucose Metabolism on Results of Cabg for High Risk Patients

Abstract

Aimto study influence of BMI and glucose metabolism on results of CABG for high-risk patients. Materialretrospective analysis of 194 high-risk patients who were discharged after CABG. Resultsanalysis of the BMI shown that 35 (18.04%) patients had normal weight, 86 (44.3%) - were overweight, I stage obesity had 58 (29.8%), II stage – 13 (6.7%), III st. obesity diagnosed in 2 (1.03%) cases. Impaired glucose metabolism was found in 132 (68.04%) patients. Type 2 DM had 50 (25.7%) patients, between which only 4 (8%) had BMI < 25 kg/m2, 46 (92%) – BMI > 25 kg/m2. IGT had 82 (42.2%) patients among which 15 (18.2%) had normal weight, 67 (81.7%) – BMI > 25 kg/m2. For all patients we performed CABG, in 187 (96.3%) cases off-pump. Average number of grafts was 3.37±0.96. Compering postoperative period of patients with BMI < 25 kg/m2 & normal glucose metabolism (n=16) against patients with BMI > 25 kg/m2 & impaired glucose metabolism (n=113) we found atrial fibrillation in 1 (6.25%) against 30 (26.5%) cases (p=0.0753); neurological dysfunctions 0 (0%) against 6 (5.3%), p=0.3452; wound infections 0 (0%) against 4 (3.5%), p=0.4446; pneumonia 0 (0%) against 4 (3.5%), p=0.4446 and acute kidney injury 0 (0%) against 2 (1.7%), p=0.5917. Conclusionsin high-risk patients with CAD before CABG impaired glucose metabolism diagnosed in 132 (68.04%) cases and BMI > 25 kg/m2 – in 159 (81.9%). Metabolic disorders influenced on appearance of infection, neurological and arrhythmic complications in early postoperative period. Off-pump CABG minimizes postoperative complications for high-risk patients.