Off-pump versus on-pump coronary artery bypass surgery in patients with actively treated diabetes and multivessel coronary disease

Benedetto, Umberto; Caputo, Massimo; Vohra, Hunaid A.; Davies, Aled; Hillier, James; Bryan, Alan J.; Angelini, Gianni

doi:10.1016/j.jtcvs.2016.06.038

Cited by 25 publications

(16 citation statements)

References 32 publications

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“…Deaths due to cardiovascular disease account for 80% of total deaths from T2DM (Yandrapalli et al, 2017). Surgery is the preferred treatment for diabetic heart disease, and during the operation, blood glucose and blood pressure should be strictly monitored (Benedetto et al, 2016). For oral medicine, the benefits of aspirin for secondary prevention of DM are currently undisputed (Capodanno and Angiolillo, 2016).…”

Section: Diabetic Heart Diseasementioning

confidence: 99%

Adjuvant Therapy With Mushroom Polysaccharides for Diabetic Complications

Jiang

Meng

et al. 2020

Front. Pharmacol.

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Background: Diabetic complications seriously endanger the health of most diabetic patients around the world. Most chemical hypoglycemic agents have adverse effects and are unable to improve the progression of diabetic complications. In recent years, a number of medicinal herbs have become increasingly popular for the treatment of diabetic complications due to their relative safety. Polysaccharides extracted from medicinal herbs with multiple pharmacological activities and low toxicity have been reported to be useful in the treatment of diabetic complications. Methods: Primary studies with keywords including polysaccharide and diabetic complications were retrieved from the Web of Science and NCBI databases and were read and analyzed. Results: Mushroom polysaccharides were proven to have positive effects on diabetic complications. Conclusions: We studied the effects of mushroom polysaccharides on hyperglycemia and as adjuvant therapies for diabetic complications and summarized the applications and limitations of mushroom polysaccharides to better understand their application for the treatment of diabetic complications.

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Section: Diabetic Heart Diseasementioning

confidence: 99%

Adjuvant Therapy With Mushroom Polysaccharides for Diabetic Complications

Jiang

Meng

et al. 2020

Front. Pharmacol.

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“…Therefore, performance of off-pump CABG in such patients would be even more demanding than in patients with localized CAD. The Bristol group recently reported one of the largest series (n=2,450; 995 propensity matched pairs) with the longest follow-up on the impact of off-pump CABG in diabetic patients with multi-vessel coronary disease (67). Although off-pump CABG was associated with a significantly increased rate of incomplete revascularization (14% vs. 7.4%; P<0.001) as compared to those undergoing on-pump CABG, no difference was detected in 30-day mortality (2.5% vs. 1.9%; P=0.4) or the need for renal replacement therapy (4.9% vs. 4.3%; P=0.5), and more importantly patients had significantly lesser postoperative complications (10.6% vs. 14.7%; P=0.005) if they underwent off-pump CABG.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Current outcomes of off-pump coronary artery bypass grafting: evidence from real world practice

Davierwala

2016

J. Thorac. Dis.

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Coronary artery bypass grafting (CABG) can be performed conventionally using cardiopulmonary bypass (CPB) and aortic clamping or on a beating heart (BH) without the use of CPB, the so-called off-pump CABG. Some surgeons, who are proponents of off-pump CABG, preferentially use this technique for the majority of operations, whereas others use it only in certain situations which warrant avoidance of CPB. Ever since the conception of off-pump CABG, the never-ending debate about which technique of CABG is safe and efficacious continues to date. Several randomized controlled trials (RCTs) have been conducted that have either favored on-pump CABG or have failed to show a significant difference in outcomes between the two techniques. However, these RCTs have been fraught with claims that they do not represent the majority of patients undergoing CABG in real world practice. Therefore, assessment of the benefits and drawbacks of each technique through observational and registry studies would be more representative of patients encountered in daily practice. The present review examines various retrospective studies and meta-analyses of observational studies that compare the early and long-term outcomes of off- and on-pump CABG, which assesses their safety and efficacy. Additionally, their outcomes in older patients, females, and those with diabetes mellitus, renal dysfunction, presence of ascending aortic disease, and/or acute coronary syndrome (ACS) have also been discussed separately. The general consensus is that early results of off-pump CABG are comparable to or in some cases better than on-pump CABG. However, on-pump CABG provides a survival benefit in the long term according to a majority of publications in literature.

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“…14,15 Su seguridad fue demostrada en distintos estudios que reportaron sus ventajas, especialmente en pacientes de alto riesgo quirúrgico, diabéticos y mayores de 80 años. [16][17][18] Su adopción por diferentes centros fue progresivamente en aumento y hoy en día representa el 60% de las cirugías coronarias en Asia y el 15-20% en el mundo occidental. 19 -21 Iniciamos su uso el año 2004, adquiriendo una experiencia progresiva hasta llegar a realizar más de un 25% de nuestras cirugías coronarias con ella entre los años 2006 y 2008.…”

Section: Discussionunclassified