Diabetes mellitus and morbidity and mortality risks after coronary artery bypass surgery.

O Risum, M Abdelnoor, J L Svennevig, K Levorstad, L Gullestad, R Bjørnerheim, S Simonsen, S Nitter-Hauge
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引用次数: 52

Abstract

Of 1025 patients (912 men, 113 women) who underwent coronary artery bypass grafting and were followed up for a mean of 7.4 years, 45 (4.4%) had diabetes mellitus. Norwegian population is 1.8-2%). Early mortality was not significantly greater among diabetics than in non-diabetics (2.2 vs. 3.1%, odds ratio--OR-0.44, confidence interval--CI- 0.05-3.56). Diabetic patients had no increased risk of perioperative myocardial infarction (OR = 0.87, CI 0.36-2.10) or of low-output syndrome necessitating intraortic balloon pumping (OR = 0.42, CI 0.55-3.05), and no excess incidence of late non-fatal myocardial infarction (relative risk = 0.69, CI 0.10-1.28) or late chronic heart failure (OR = 2.50, CI 0.5-11.0). Long-term mortality was increased in the diabetic patients (relative risk 1.87, CI 1.60-2.14). Thus diabetes did not entail heightened risk of early mortality, perioperative myocardial infarction or low-output syndrome. Nor was there excess risk of recurrent angina pectoris, late non-fatal myocardial infarction or chronic heart failure among the diabetic patients, but the late mortality risk was increased.

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冠状动脉搭桥术后糖尿病及发病率和死亡率风险。
1025例患者(912例男性,113例女性)行冠状动脉旁路移植术,平均随访7.4年,其中45例(4.4%)患有糖尿病。挪威人口为1.8-2%)。糖尿病患者的早期死亡率没有显著高于非糖尿病患者(2.2 vs 3.1%,优势比-OR-0.44,置信区间-CI- 0.05-3.56)。糖尿病患者围手术期心肌梗死(OR = 0.87, CI 0.36-2.10)或需要主动脉内球囊泵送的低输出综合征(OR = 0.42, CI 0.55-3.05)的风险没有增加,晚期非致死性心肌梗死(相对风险= 0.69,CI 0.10-1.28)或晚期慢性心力衰竭(OR = 2.50, CI 0.5-11.0)的发生率没有增加。糖尿病患者的长期死亡率增加(相对危险度1.87,CI 1.60-2.14)。因此,糖尿病不会增加早期死亡、围手术期心肌梗死或低输出综合征的风险。糖尿病患者复发性心绞痛、晚期非致死性心肌梗死或慢性心力衰竭的风险也没有增加,但晚期死亡风险有所增加。
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