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Type 2 Diabetes Mellitus and In-Hospital Major Adverse Cardiac and Cerebrovascular Events (Macces) and Postoperative Complications Among Patients Undergoing On-Pump Isolated Coronary Artery Bypass Surgery in Northeastern Iran Publisher Pubmed



Nomali M1, 2 ; Ayati A3 ; Tayebi A4 ; Heidari ME5 ; Moghaddam K6 ; Mosallami S6 ; Riahinokandeh G7 ; Nomali M1, 2 ; Roshandel G9
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Clinical Research Development Unit (CRDU), Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
  5. 5. Student Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Kordkuy Amiralmomenin Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  7. 7. Department of Surgery, School of Medicine, Sayyad Shirazi Hospital, Kordkuy Amiralmomenin Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  8. 8. Alejalil Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  9. 9. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran

Source: BMC Cardiovascular Disorders Published:2023


Abstract

Background: Diabetes Mellitus (DM) is a rapidly growing disorder worldwide, especially in the Middle East. A higher incidence of coronary artery diseases requiring coronary artery bypass graft (CABG) surgery has been reported in patients with diabetes. We assessed the association between type 2 diabetes mellitus (T2DM) and in-hospital major adverse cardiac and cerebrovascular events (MACCEs) and postoperative complications among patients who underwent on-pump isolated CABG. Methods: In this retrospective cohort study, we used the data registered for CABG patients from two heart centers in the Golestan province (North of Iran) between 2007 and 2016. The study population included 1956 patients divided into two groups: 1062 non-diabetic patients and 894 patients with diabetes (fasting plasma glucose ≥126 mg/dl or using antidiabetic medications). The study outcome was in-hospital MACCEs, a composite outcome of myocardial infarction (MI), stroke and cardiovascular death, and postoperative complications, including postoperative arrhythmia, acute atrial fibrillation (AF), major bleeding (defined as reoperation due to bleeding), and acute kidney injury (AKI). Results: During the 10-year study period, 1956 adult patients with a mean (SD) age of 59.0 (9.60) years were included. After adjustment for age, gender, ethnicity, obesity, opium consumption, and smoking, diabetes was a predictor of postoperative arrhythmia (AOR 1.30, 95% CI 1.08–1.57; P = 0.006). While it was not a predictor of in-hospital MACCEs (AOR 1.35, 95% CI 0.86, 2.11; P = 0.188), AF (AOR 0.85, 95% CI 0.60–1.19; P = 0.340), major bleeding (AOR 0.80, 95% CI 0.50, 1.30; P = 0.636) or AKI (AOR 1.29, 95% CI 0.42, 3.96; P 0.656) after CABG surgery. Conclusion: Findings indicated that diabetes increased the risk of postoperative arrhythmia by 30%. However, we found similar in-hospital MACCEs, acute AF, major bleeding, and AKI following CABG surgery in both diabetic and non-diabetic patients. © 2023, The Author(s).