Impact of diabetes mellitus and renal insufficiency on 5-year mortality following coronary artery bypass graft surgery: a cohort study of 4869 UK patients

Gallagher, Sean; Kapur, Akhil; Lovell, Matthew J.; Jones, Daniel A.; Kirkwood, Amy A.; Hassan, Sevda; Archbold, R. Andrew; Wragg, Andrew; Uppal, Rakesh; Yaqoob, Muhammad

doi:10.1093/ejcts/ezt630

Cited by 29 publications

(33 citation statements)

References 22 publications

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“…Earlier studies on revascularization reported patients' prognoses in relation to the presence or absence of DM and in relation to treatment with or without insulin, not according to the subtype of DM [8][9][10]. One study found that high HbA1c levels were associated with the progression and severity of coronary artery disease [11].…”

Section: Introductionmentioning

confidence: 99%

Relationship between preoperative hemoglobin A1c levels and long-term mortality after coronary artery bypass grafting in patients with type 2 diabetes mellitus

Kuhl

Sartipy

Eliasson

et al. 2016

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Relationship between preoperative hemoglobin A1c levels and long-term mortality after coronary artery bypass grafting in patients with type 2 diabetes mellitus

Kuhl

Sartipy

Eliasson

et al. 2016

International Journal of Cardiology

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“…Patients with diabetes and established CHD often have more complicated atherosclerosis and are at higher risk of developing major adverse CVD events and death than are patients without diabetes (7)(8)(9)(10).…”

mentioning

confidence: 99%

Glycemic Control in Type 1 Diabetes and Long-Term Risk of Cardiovascular Events or Death After Coronary Artery Bypass Grafting

Nyström

Holzmann

Eliasson

et al. 2015

Journal of the American College of Cardiology

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“…Multivariate regression analysis revealed that age, LVEF, EuroScore, and diabetes were independent predictors, findings which were similar to those of previous studies. 28,29) Of note, eGFR was a significant predictor in univariate analysis, while its predictive power was markedly weakened by other risk factors, such as LVEF and EuroScore in multivariate analysis. Regarding CABG, aged patients with left ventricular dysfunction and a higher EuroScore implied patients were more likely to have comorbidities, more procedural risks, and a higher incidence of complications, which probably increased in-hospital mortality.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft in Aged Patients With Unprotected Left Main Artery Lesions

et al. 2016

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SummaryThere is still much debate about revascularization strategies in aged patients with unprotected left main coronary artery (UPLM) lesions. This study compared the outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in this population.A total of 126 patients older than 60 years of age with LM lesions who underwent revascularization in our hospital from January 2012 to December 2013 were followed up for an average of 15.2 months. The cumulative incidence of major adverse cardiac and cerebral events (MACCE) was estimated by Kaplan-Meier plots. During follow-up, the CABG group had higher proportions of cardiac death, stroke, and worsening of heart failure while the PCI group had a higher proportion of recurrence of angina (P = 0.04). The MACCE incidence was lower in the PCI group than that in the CABG group (28.9% versus 35.6%, P = 0.04). Multivariate regression identified left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate (eGFR) as predictors of PCI, while age, LVEF, EuroScore, and diabetes were the predictors of CABG. PCI maintained its superiority over CABG after adjustment for risk factors (Hazard ratio: 0.28, P = 0.004). The CABG group included a higher proportion of severe hemorrhagic complications than the PCI group (P = 0.04).In terms of efficacy and safety, PCI had an advantage over CABG in aged patients with UPLM lesions. Thus, PCI was a reasonable alternative to CABG for this population. (Int Heart J 2016; 57: 682-688) Key words: Left main coronary artery, Predictor, Revascularization, Major adverse cardiac and cerebral events C oronary artery bypass graft (CABG) remains the preferable strategy for unprotected left main artery (UPLM) lesions in the recent guideline. 1) However, accompanied by the emergence of drug-eluting stents (DES) and intravascular ultrasound (IVUS), percutaneous coronary intervention (PCI) has made great progress. Particularly for UPLM, previous studies have reported a low incidence of cardiac death and stent thrombosis 2-4) and the therapeutic effect was similar to that of CABG. 5,6) In the real world, increasing numbers of patients with LM lesions are also suitable candidates for PCI. Many prefer PCI to CABG because of aging, physical status, personal preference, and other factors. Thus, whether PCI of UPLM is superior to CABG in aged patients is a noteworthy topic. Only a few studies have examined this problem and the results were inconsistent. 7,8) We therefore carried out an observational study to evaluate whether PCI of UPLM in aged patients is superior to CABG. We also assessed likely predictors of the two revascularization strategies. MethodsStudy population: A total of 126 patients older than 60 years with LM lesions who underwent revascularization in our hospital from January 2012 to December 2013 were included in this study cohort. All of the patients were assessed with respect to the severity of coronary artery lesions by angiography. The patients with a SYNTAX score > 32 were recommended...

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Impact of diabetes mellitus and renal insufficiency on 5-year mortality following coronary artery bypass graft surgery: a cohort study of 4869 UK patients

Cited by 29 publications

References 22 publications

Relationship between preoperative hemoglobin A1c levels and long-term mortality after coronary artery bypass grafting in patients with type 2 diabetes mellitus

Relationship between preoperative hemoglobin A1c levels and long-term mortality after coronary artery bypass grafting in patients with type 2 diabetes mellitus

Glycemic Control in Type 1 Diabetes and Long-Term Risk of Cardiovascular Events or Death After Coronary Artery Bypass Grafting

Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft in Aged Patients With Unprotected Left Main Artery Lesions

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