scholarly journals Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery

2021 ◽  
Vol 10 (12) ◽  
pp. 2739
Author(s):  
Muhammad Abu Tailakh ◽  
Shlomo-yaron Ishay ◽  
Jenan Awesat ◽  
Liat Poupko ◽  
Gidon Sahar ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Hemoglobin A1c ◽  
Smoking Status ◽  
Artery Bypass ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Hba1c Levels

Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 ± 1.7%, where 206 (35.6%) patients had an HbA1c ≤ 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c ≤ 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.

Abstract 2298: Impact of Preopeartive Anemia on Long-term Outcomes Following Isolated Coronary Artery Bypass Surgery

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Yan Li ◽  
Zhe Zheng ◽  
Shiju Zhang ◽  
Xianqiang Wang ◽  
Huawei Gao ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Total Mortality ◽  
Long Term Outcomes ◽  
Preoperative Anemia ◽  
Cabg Surgery ◽  
Repeated Revascularization

Background: The prognostic and clinical value of preopeartive anemia in patients undergoing cardiac surgery has recently been recognized. However, very limited information exists on the impact of preopeartive anemia on long-term outcomes following coronary artery bypass graft (CABG) surgery. This study aimed at examining the degree to which preopeartive anemia affects long-term outcomes after isolated CABG surgery. Methods: A unicenter study was conducted on 5488 consecutive survivors of isolated CABG between January 1999 and December 2005. Preopeartive anemia was defined according to the World Health Organization definition (hemoglobin < 13g/dL for male; hemoglobin < 12g/dL for female). Long-term outcomes of interest were total mortality, myocardial infarction (MI), repeated revascularization, and major adverse cardiac events (MACEs=total mortality or MI or repeated revascularization). These outcomes were compared after adjustment for differences in baseline risk factors among the patients. Results: 1437 (26.2%) patients had preoperative anemia. After a mean follow-up of 43.3±18.3 months, preoperative anemia was found to be an independent risk factor for total mortality (hazard ration [HR]: 1.490; 95% CI: 1.074 to 2.067; p=0.017), MI (HR: 1.595; 95% CI: 1.028 to 2.474; p=0.037) and MACEs (HR: 1.363; 95% CI: 1.059 to 1.755; p=0.016). We also found that aspirins and beta-blockers were underused in patients with anemia during follow-up. Conclusions: Preopeartive anemia has a strong negative impact on long-term outcomes following isolated CABG. Our data also suggest that the incorporation of preoperative anemia into the risk assessments of long-term outcomes after CABG is recommended. Future intense and systematic studies are needed to help ensure high-quality cardiac care of patients with anemia.

Long-term follow-up after coronary artery bypass

1978 ◽  
Vol 45 (1) ◽  
pp. 162-165 ◽  
Author(s):  
R. J. Hall ◽  
E. Garcia ◽  
V. S. Mathur ◽  
U. Busch ◽  
D. A. Cooley ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Long Term Follow Up

scholarly journals Sex-specific outcome after minimally invasive direct coronary artery bypass for single-vessel disease

2019 ◽  
Vol 30 (3) ◽  
pp. 380-387
Author(s):  
Christine Friedrich ◽  
Rouven Berndt ◽  
Assad Haneya ◽  
René Rusch ◽  
Rainer Petzina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Survival Rates ◽  
Vessel Disease ◽  
Single Vessel ◽  
Single Vessel Disease

Abstract OBJECTIVES Female gender is reported as an independent risk factor for a poor outcome after coronary artery bypass grafting. We analysed the influence of gender on surgical outcome in patients with single-vessel disease undergoing minimally invasive direct coronary artery bypass (MIDCAB). METHODS From January 1998 to December 2016, a total of 607 consecutive patients with single-vessel disease (31.9% women) underwent MIDCAB at our institution. Major adverse cardiac and cerebrovascular events (MACCE) were recorded during a median follow-up period of 8.0 years. Survival time was estimated for all patients and after applying propensity score matching (138 women vs 138 men). Multivariable Cox regression analysis identified risk factors predicting a long-term mortality rate. RESULTS In women, a longer surgical time (125 vs 113 min; P &lt; 0.001) and a higher transfusion rate were recorded (13.0% vs 5.1%; P = 0.001) with similar rates of in-hospital deaths (1.0% vs 0.5%; P = 0.60) and MACCE (1.5% vs 0.7%; P = 0.39). Survival and MACCE-free survival during the follow-up period did not differ significantly between genders (P = 1.0, P = 0.36). Survival and MACCE-free survival rates after 5 years were 94% and 90% in women compared to 91% and 86% in men. Propensity score matching demonstrated improved long-term survival rates in women (P = 0.029). Insulin-dependent diabetes mellitus, postoperative atrial fibrillation and prolonged intensive care unit stay were associated with long-term deaths for both genders, whereas obesity, former myocardial infarction and preoperative atrial fibrillation were significant risk factors in men. CONCLUSIONS Female patients showed no adverse outcomes after MIDCAB, although risk factors were gender-specific. Overall, MIDCAB demonstrated excellent short- and long-term results as a treatment for single-vessel disease in both genders.

scholarly journals Long-term outcomes after coronary artery bypass surgery in patients with diabetes

2020 ◽  
Vol 30 (5) ◽  
pp. 685-690
Author(s):  
Tomas Andri Axelsson ◽  
Jonas A Adalsteinsson ◽  
Linda O Arnadottir ◽  
Dadi Helgason ◽  
Hera Johannesdottir ◽  
...  
Keyword(s):  
Overall Survival ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Long Term Outcomes ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract OBJECTIVES Our aim was to investigate the outcome of patients with diabetes undergoing coronary artery bypass grafting (CABG) surgery in a whole population with main focus on long-term mortality and complications. METHODS This was a nationwide retrospective analysis of all patients who underwent isolated primary CABG in Iceland between 2001 and 2016. Overall survival together with the composite end point of major adverse cardiac and cerebrovascular events was compared between patients with diabetes and patients without diabetes during a median follow-up of 8.5 years. Multivariable regression analyses were used to evaluate the impact of diabetes on both short- and long-term outcomes. RESULTS Of a total of 2060 patients, 356 (17%) patients had diabetes. Patients with diabetes had a higher body mass index (29.9 vs 27.9 kg/m2) and more often had hypertension (83% vs 62%) and chronic kidney disease (estimated glomerular filtration rate ≤60 ml/min/1.73 m2, 21% vs 14%). Patients with diabetes had an increased risk of operative mortality [odds ratio 2.52, 95% confidence interval (CI) 1.27–4.80] when adjusted for confounders. 5-Year overall survival (85% vs 91%, P &lt; 0.001) and 5-year freedom from major adverse cardiac and cerebrovascular events were also inferior for patients with diabetes (77% vs 82%, P &lt; 0.001). Cox regression analysis adjusting for potential confounders showed that the diagnosis of diabetes significantly predicted all-cause mortality [hazard ratio (HR) 1.87, 95% CI 1.53–2.29] and increased risk of major adverse cardiac and cerebrovascular events (HR 1.47, 95% CI 1.23–1.75). CONCLUSIONS Patients with diabetes have significantly lower survival after CABG, both within 30 days and during long-term follow-up.

scholarly journals Risk-Adjusted Short- and Long-Term Outcomes for On-Pump Versus Off-Pump Coronary Artery Bypass Surgery

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Matthew L. Williams ◽  
Lawrence H. Muhlbaier ◽  
Jacob N. Schroder ◽  
Jonathan A. Hata ◽  
Eric D. Peterson ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Long Term Outcomes ◽  
Short Term ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
To Receive

Background— Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) remains poorly defined. Methods and Results— Using logistic regression analysis and proportional hazards modeling, short-term and long-term outcomes (perioperative mortality and complications, risk-adjusted survival, and survival/freedom from revascularization) were investigated for patients who underwent OPCAB (641 patients) and CABG-cardiopulmonary bypass (5026 patients) from 1998 to 2003 at our institution. For these variables, follow-up was 98% complete. OPCAB patients were less likely to receive transfusion (odds ratio for OPCAB, 0.80; P =0.037), and there were trends toward improvement in other short-term outcomes compared with CABG-cardiopulmonary bypass. Long-term outcomes analysis demonstrated no difference in survival, but OPCAB patients were more likely to require repeat revascularization (OPCAB hazard ratio, 1.29; P =0.020). Conclusions— OPCAB patients were less likely to receive transfusion during their hospitalization for surgery but had higher risk for revascularization in follow-up. These results highlight the need for a large randomized, controlled trial to compare these 2 techniques.

scholarly journals Clinical and Angiographic Outcomes in Coronary Artery Bypass Surgery with Multiple versus Single Distal Target Grafts

2017 ◽  
Vol 20 (4) ◽  
pp. 132
Author(s):  
Aws Alherbish ◽  
Colleen M Norris ◽  
Jay Shavadia ◽  
Mohammad Almutawa ◽  
Seraj Abualnaja ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Graft Failure ◽  
Artery Bypass ◽  
Population Based ◽  
Complete Revascularization ◽  
Graft Material ◽  
Cabg Patients

Background: Coronary artery bypass grafting (CABG) with multiple distal target (MDT) grafts requires less graft material and reduces cardiopulmonary bypass time; however, there may be a higher incidence of graft failure. A real-world analysis reporting long-term outcomes associated with MDT grafts is lacking.Material and Methods: In 6262 consecutive patients who underwent an isolated first CABG from 2004-2012, patients with MDTs were propensity matched to those with single distal target (SDT) grafts. Logistic regression adjusted for traditional, anatomical, and functional definitions of complete revascularization (CR). Outcomes included 30-day, 1-year, and long-term mortality (median 6.29 years). Results: A total of 549 (8.8%) CABG patients had a MDT graft. CR defined using traditional (96.1% versus 92.0%, P = .005), anatomical (89.0% versus 80.20%, P < .001), and functional (90.7% versus 82.6, P < .001) definitions was more frequent in MDT patients. No significant differences in mortality were observed at 30 days (2% versus 3.3%, P = .18), 1-year (3.8% versus 4.9%, P = .37), or through end of follow-up (18.0% versus 16.6% P = .52) between the MDT and SDT groups, respectively. Similarly, no differences were observed after adjustment for all definitions of CR. Graft failure in MDT and SDT patients was 37.8% and 27.6%, respectively (P = .18).Conclusion: In a contemporary population-based cohort, no differences in mortality were observed between CABG patients with MDT and SDT grafts. Our findings support the safety of MDT grafts to facilitate CR in patients and when graft material is limited.

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