Long‐Term Risk of Stroke in Patients With Type 1 and Type 2 Diabetes Following Coronary Artery Bypass Grafting

Abstract

BackgroundWe performed a nationwide population‐based cohort study to investigate the long‐term risk of stroke after coronary artery bypass grafting in patients with type 1 and type 2 diabetes.Methods and ResultsAll patients who underwent primary coronary artery bypass grafting in Sweden from 2000 through 2011 were included from the SWEDEHEART register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all‐cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. We used multivariable Cox regression to estimate the risk of stroke in relation to type of diabetes. A total of 53 820 patients (type 1 diabetes [n=714], type 2 diabetes [n=10 054], no diabetes [n=43 052]) were included. During a mean follow‐up of 7.4 years (398 337 person‐years), in total, 8.0% (n=4296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% CI) for all stroke was 1.59 (1.20–2.11) in type 1 diabetes, and 1.32 (1.23–1.43) in type 2 diabetes.ConclusionsThe long‐term risk for stroke after coronary artery bypass grafting was increased in patients with type 1 and type 2 diabetes, compared to patients with no diabetes.

Diabetes, Vascular Aging and Stroke: Old Dogs, New Tricks?

“…A Swedish study included all the patients who had undergone coronary artery bypass grafting for 12 years [ 45 ]. Both DM types were associated with an increased risk of stroke [ 45 ].…”

“…A Swedish study included all the patients who had undergone coronary artery bypass grafting for 12 years [ 45 ]. Both DM types were associated with an increased risk of stroke [ 45 ]. Impressively, mortality was significantly higher in T1DM and only slightly increased in T2DM [ 45 ].…”

“…Both DM types were associated with an increased risk of stroke [ 45 ]. Impressively, mortality was significantly higher in T1DM and only slightly increased in T2DM [ 45 ]. Specifically, the all-cause mortality rate was 22% for T1DM and 21% for T2DM [ 45 ].…”

Myocardial revascularization in patients with coronary heart disease and type 2 diabetes

“…При более длительном наблюдении результаты КШ у больных СД заметно уступают пациентам без этой па-тологии [5,17,33,51,52]. Так, СД существенно ухудшал долговременное выживание после КШ по сравнению с больными без СД, был независимым предиктором сердечно-сосудистых событий при длительном на-блюдении [5,17,51,52].…”

“…Так, СД существенно ухудшал долговременное выживание после КШ по сравнению с больными без СД, был независимым предиктором сердечно-сосудистых событий при длительном на-блюдении [5,17,51,52]. При этом предиктором не-благоприятных долговременных результатов после КШ, по данным Zhang H., был СД с приемом ПСПП и инсулина, но не диабет, корригируемый диетой [33].…”