scholarly journals Did blood transfusion increase mortality in patients with diabetes undergoing isolated coronary artery bypass graft surgery? A propensity score-matched analysis of 816 patients

2020 ◽  
Vol 28 (4) ◽  
pp. 586-592
Author(s):  
Muharrem Koçyiğit
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery ◽  
Blood Transfusion ◽  
Confidence Interval ◽  
Coronary Artery Bypass ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Patients With Diabetes ◽  
Pump Coronary Artery Bypass

Background: The aim of this study was to compare clinical outcomes of blood transfusion in patients with diabetes mellitus undergoing isolated on-pump coronary artery bypass grafting. Methods: The medical records of a total of 1,912 patients (1,300 males, 612 females; mean age 60.7±10.0) with diabetes who underwent isolated on-pump coronary artery bypass grafting between January 1999 and June 2019 were retrospectively analyzed. The patients were divided into two groups as patients with and without blood transfusions. The mortality rates were compared between the two groups. Results: The mortality rate was 14 times higher in the patients receiving blood transfusion (odds ratio: 14.80; 95% confidence interval 5.05 to 43.34; p<0.001). However, in the multivariate logistic regression analysis, there were no statistically significant difference in mortality between the patient groups, when diabetes mellitus was a covariate factor (Odds ratio: 8.34; 95% confidence interval 3.94 to 17.66 vs. odds ratio 8.36; 95% confidence interval 3.95 to 17.70). Conclusion: The propensity score-matched analysis of patients with diabetes showed that clinical outcomes were more severely affected by blood transfusion.

scholarly journals Sleep apnea and diabetes mellitus are independently associated with cardiovascular events and hospitalization for heart failure after coronary artery bypass grafting

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aye-Thandar Aung ◽  
Chieh-Yang Koo ◽  
Wilson W. Tam ◽  
Zhengfeng Chen ◽  
William Kristanto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Coronary Artery ◽  
Sleep Apnea ◽  
Coronary Artery Bypass Grafting ◽  
Confidence Interval ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

AbstractThe relative and combined effects of sleep apnea with diabetes mellitus (DM) on cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG) remain unknown. In this secondary analysis of data from the SABOT study, 1007 patients were reclassified into four groups based on their sleep apnea and DM statuses, yielding 295, 218, 278, and 216 patients in the sleep apnea (+) DM (+), sleep apnea (+) DM (−), sleep apnea (−) DM (+), and sleep apnea (−) DM (−) groups, respectively. After a mean follow-up period of 2.1 years, the crude incidence of major adverse cardiac and cerebrovascular event was 18% in the sleep apnea (+) DM (+), 11% in the sleep apnea (+) DM (−), 13% in the sleep apnea (−) DM (+), and 5% in the sleep apnea (−) DM (−) groups. Using sleep apnea (−) DM (−) as the reference group, a Cox regression analysis indicated that sleep apnea (+) and DM (+) independently predicted MACCEs (adjusted hazard ratio, 3.2; 95% confidence interval, 1.7–6.2; p = 0.005) and hospitalization for heart failure (adjusted hazard ratio, 12.6; 95% confidence interval, 3.0–52.3; p < 0.001). Sleep apnea and DM have independent effects on the prognosis of patients undergoing CABG.Clinical trial registration: ClinicalTrials.gov identification no. NCT02701504.

P187 Late outcomes of all patients at a single center with diabetes mellitus undergoing SYNTAX scoring after angiographic screening for the FREEDOM trial

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
G Femia ◽  
S Kim ◽  
S Burgess ◽  
M Eftal ◽  
I Ullah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Medical Therapy ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Vessel Disease ◽  
Patients With Diabetes

Abstract Background The Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multi-Vessel Disease (FREEDOM) trial randomized only a minority of screened patients with diabetes mellitus (DM) and 2-3 vessel disease (MVD), representing an high risk diabetic MVD cohort. Methods Consecutive patients with DM underwent angiographic screening from June 2006  to March 2010 at Liverpool Hospital, Sydney, Australia, for the FREEDOM trial; SYNTAX Scores (SS) were subsequently performed. Patients had late follow-up to determine late rates of death, non-fatal MI and stroke. Results Among 1263 patients with DM 833 (66%) had 0-1 vessel disease and 430 (34%) had MVD of whom 139 had prior coronary artery bypass grafting (CABG), and SS were 0 in 272, 1-9 in 336, 10-22 in 264, 23-32 in 109, and 271 patients had SS ≥33. Revascularisation was performed by coronary artery bypass grafting (CABG) in 139 (11%), 486 (38%) underwent PCI, and 638 (51%) did not undergo a revascularization procedure; respective mean ages were 63.5, 64.2 and 64.7 years; p = 0.39, and presentation rates with an ACS were 52%, 57% and 37%; p &lt; 0.05. Amongst patients with MVD, those undergoing CABG had lower rates of MACE than either PCI or medical therapy (22%, 40%, and 51% respectively; p &lt; 0.001). Kaplan-Meier curves (Figure) with respect to SS and late events are shown for: A) Death; B) Non-fatal MI; C) Death/MI/Stroke; D) Late Revascularization. Multi-variable analyses found independent predictors of late mortality were age &gt;75 (HR 6.2), prior MI (HR 1.1), prior CABG (HR 1.6); and LVEF &lt;40% (all p &lt; 0.05). Predictors of late MI were older age, ACS presentation at screening, LVEF &lt; 40% and insulin use. Conclusions Among diabetic patients who screened for the FREEDOM Trial, among 34% with MVD CABG was associated with lower rates of non-fatal MI and MACE compared to PCI and medical therapy. The poorest outcomes were observed in DM patients with MVD managed with medical therapy alone. Abstract P187 Figure. SYNTAX scores &late events in diabetics

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