7-year outcomes in diabetic patients after coronary artery bypass graft in a developing country

BMC Cardiovascular Disorders

Research

Ali Vasheghani-Farahani¹  Farzad Masoudkabir²  Shahram Momtahan³  Soheil Mansourian³  Parmida Sadat Pezeshki⁴  Arash Jalali⁵  Mina Pashang⁵  Abbasali Karimi⁵  Saeed Sadeghian⁵  Kaveh Hosseini⁵ 

[1] Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Cardiovascular Diseases Research Institute, Tehran Heart Center, Kargar Street, Jalal al-Ahmad Crossroads, 1411713138, Tehran, Iran;Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran;Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;

关键词: Diabetes;    Coronary artery bypass graft surgery;    Major adverse cardiac and cerebrovascular events;    Acute coronary syndrome;    Revascularization;   

DOI  :  10.1186/s12872-023-03279-8

 received in 2023-03-05, accepted in 2023-05-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRevascularization in diabetic patients with coronary artery disease remains a challenge in cardiology practice. Although clinical trials have reported the mid-term superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention in these patients, little is known about the long-term outcomes of CABG in diabetic patients compared to non-diabetics, particularly in developing countries.MethodsBetween 2007 and 2016, we recruited all patients who underwent isolated CABG in a tertiary care cardiovascular center in a developing country. The patients were followed at 3–6 months and 12 months after surgery, and then annually. The study endpoints were 7-year all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).ResultsOf 23,873 patients (17,529 males, mean age 65.67 years) who underwent CABG, 9227 (38.65%) patients were diagnosed with diabetes. After adjustment for potential confounders, patients with diabetes experienced a 31% increase in MACCE seven years after surgery compared to the non-diabetic patients (HR = 1.31, 95% CI: 1.25–1.38, P-value < 0.0001). Meanwhile, diabetes contributes to a 52% increase in the risk of all-cause mortality after CABG (HR = 1.52, 95% CI: 1.42–1.61, P-value < 0.0001).ConclusionsOur study showed a higher risk of all-cause mortality and MACCE at seven years in diabetic patients undergoing isolated CABG. The outcomes in the studied center in a developing country were comparable to western centers. The high incidence of adverse outcomes in the long term in diabetic patients implies that not only short-term but long-term measures should be taken to improve the CABG outcomes in this challenging patient population.

【 授权许可】

CC BY   
© The Author(s) 2023

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