糖尿病对急性冠状动脉综合征冠状动脉旁路移植手术患者短期疗效的影响。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Perfusion-Uk Pub Date : 2025-04-01 Epub Date: 2024-05-08 DOI:10.1177/02676591241253461
Ihor Krasivskyi, Borko Ivanov, Zakaria Msallati, Clara Großmann, Stephen Gerfer, Mariya Mihaylova, Kaveh Eghbalzadeh, Christian Origel Romero, Ilija Djordjevic, Thorsten Wahlers, Farhad Bakhtiary, Anton Sabashnikov
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引用次数: 0

摘要

简介糖尿病(DM)与动脉粥样硬化和心血管疾病等并发症相关。冠状动脉旁路移植(CABG)手术是治疗患有三血管疾病的糖尿病患者的最佳疗法。众所周知,糖尿病也是导致接受择期冠状动脉旁路移植手术的患者发病率和死亡率升高的相关风险因素。有关急性冠状动脉综合征(ACS)糖尿病患者预后的数据各不相同。本研究旨在探讨糖尿病对急性冠状动脉综合征接受 CABG 手术患者短期预后的影响:方法:对2011年6月至2019年10月期间因ACS接受搭桥手术的1370名患者进行了回顾性倾向评分匹配(PSM)分析。所有患者分为两组:非糖尿病组(n = 905)和糖尿病组(n = 465)。院内死亡率是主要结果。次要结果是围手术期心肌梗死、新发透析、因出血再次开刀和重症监护室(ICU)住院时间。此外,还对胰岛素依赖型和非胰岛素依赖型糖尿病患者进行了亚组分析:进行PSM分析后,两组患者的基线特征和术前风险状况相当。非糖尿病组患者接受全动脉血运重建的比例(p = .048)和使用双侧胸内动脉的比例(p < .001)明显高于非糖尿病组。糖尿病组围手术期心肌梗死(p = .048)和新发透析(p = .008)的发生率明显高于非糖尿病组。两组患者的院内死亡率在统计学上(p = .907)相当:结论:在因急性冠状动脉综合征接受 CABG 手术的患者中,糖尿病与较高的不良预后发生率有关,但两组患者的院内死亡率相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of diabetes on short-term outcomes in patients undergoing coronary artery bypass grafting surgery in acute coronary syndrome.

IntroductionDiabetes mellitus (DM) is associated with concomitant comorbidities, such as atherosclerosis and cardiovascular disease. Coronary artery bypass grafting (CABG) surgery is the optimal therapy in diabetic patients with triple vessel disease. DM is also known to be a relevant risk factor for higher morbidity and mortality in patients who underwent elective CABG procedures. Data regarding outcomes in diabetic patients in acute coronary syndrome (ACS) is heterogeneous. This study aimed to investigate the impact of DM on short-term outcomes in patients who underwent CABG surgery in ACS.MethodsA retrospective propensity score matched (PSM) analysis of 1370 patients who underwent bypass surgery for ACS between June 2011 and October 2019 was conducted. All patients were divided into two groups: non-diabetic group (n = 905) and diabetic group (n = 465). In-hospital mortality was the primary outcome. Secondary outcomes were perioperative myocardial infarction, new onset dialysis, reopening for bleeding and duration of intensive care unit (ICU) stay. A subgroup analysis of patients with insulin-dependent and non-insulin dependent DM was also performed.ResultsAfter performing PSM analysis, baseline characteristics and the preoperative risk profile were comparable between both groups. The proportion of patients who underwent total arterial revascularization (p = .048) with the use of both internal thoracic arteries (p < .001) was significantly higher in the non-diabetic group. The incidence of perioperative myocardial infarction (p = .048) and new onset dialysis (p = .008) was significantly higher in the diabetic group. In-hospital mortality was statistically (p = .907) comparable between the two groups.ConclusionDM was associated with a higher incidence of adverse outcomes, however with comparable in-hospital mortality in patients who underwent CABG procedure for ACS.

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来源期刊
Perfusion-Uk
Perfusion-Uk 医学-外周血管病
CiteScore
3.00
自引率
8.30%
发文量
203
审稿时长
6-12 weeks
期刊介绍: Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.
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