On-Pump or Off-Pump Impact of Diabetic Patient Undergoing Coronary Artery Bypass Grafting 5-Year Clinical Outcomes.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-09-24 eCollection Date: 2024-09-01 DOI:10.31083/j.rcm2509349

Fei Xu, Lei Li, Chenghui Zhou, Sheng Wang, Hushan Ao

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Abstract

Background: For diabetic patients undergoing coronary artery bypass grafting (CABG), there is still a debate about whether an off-pump or on-pump approach is advantageous.

Methods: A retrospective review of 1269 consecutive diabetic patients undergoing isolated, primary CABG surgery from January 1, 2013 to December 31, 2015 was conducted. Among them, 614 received non-cardiopulmonary bypass treatment during their operation (off-pump group), and 655 received cardiopulmonary bypass treatment (on-pump group). The hospitalization outcomes were compared by multiple logistic regression models with patient characteristics and operative variables as independent variables. Kaplan-Meier curves and Cox proportional-hazard regression models for mid-term (2-year) and long-term (5-year) clinical survival analyses were used to determine the effect on survival after CABG surgery. In order to further verify the reliability of the results, propensity-score matching (PSM) was also performed between the two groups.

Results: Five-year all-cause death rates were 4.23% off-pump vs. 5.95% on-pump (p = 0.044), and off-pump was associated with reduced postoperative stroke and atrial fibrillation.

Conclusions: These findings suggest that off-pump procedures may have benefits for diabetic patients in CABG.

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糖尿病患者接受冠状动脉旁路移植术的 5 年临床疗效受泵上或泵下的影响。

背景：对于接受冠状动脉旁路移植术（CABG）的糖尿病患者，目前仍在争论采用非泵还是泵上方法更有优势：方法：对 2013 年 1 月 1 日至 2015 年 12 月 31 日期间连续接受孤立、初级 CABG 手术的 1269 例糖尿病患者进行了回顾性研究。其中，614 人在手术过程中接受了非心肺旁路治疗（非泵组），655 人接受了心肺旁路治疗（泵组）。以患者特征和手术变量为自变量，通过多元逻辑回归模型对住院结果进行比较。采用 Kaplan-Meier 曲线和 Cox 比例危险回归模型进行中期（2 年）和长期（5 年）临床生存分析，以确定对 CABG 术后生存的影响。为了进一步验证结果的可靠性，还在两组患者之间进行了倾向分数匹配（PSM）：结果：五年全因死亡率为：非体外循环 4.23% 对体外循环 5.95%（P = 0.044），非体外循环与术后中风和心房颤动减少有关：结论：这些研究结果表明，非泵手术可能对接受 CABG 的糖尿病患者有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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