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Interact Cardiovasc Thorac Surg. 2018 Oct 15. doi: 10.1093/icvts/ivy287. [Epub ahead of print]

Male patients with diabetes undergoing coronary artery bypass grafting have increased major adverse cerebral and cardiovascular events.

Author information

1
Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
2
Department of Anesthesiology, The First affiliated Hospital, Nanchang University, Nanchang, China.
3
The Department of Information Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Abstract

OBJECTIVES:

The role of body mass index (BMI) in the prognosis of patients with diabetes undergoing coronary artery bypass grafting (CABG) has been of great interest for a long time. However, the precise relationship between BMI and major adverse cerebral and cardiovascular events (MACCEs) in these patients is still unclear. The goal of this study was to investigate the outcome of patients with diabetes with different BMIs undergoing CABG and the results from the 5-year follow-up.

METHODS:

This study included 771 patients with diabetes undergoing CABG from 1 January 2003 to 31 December 2009. They were classified based on the Chinese standard for BMI as follows: underweight: <18.5 kg/m2; normal weight: 18.5-23.9 kg/m2; overweight: 24-27.9 kg/m2; and obese: >28 kg/m2. Short-term outcomes and 5-year MACCEs were compared among various BMI groups after surgery.

RESULTS:

Obese and overweight patients with diabetes tended to be younger than normal weight patients [57 years (49-64) vs 62 years (54-68) and 64 years (59-69); P < 0.001]. There were fewer male patients (25.20% vs 17.78% and 16.54%, P = 0.041). More smokers were in the 2 groups (38.8% vs 51.55% and 57.14%, P < 0.001). Glucose concentration was highest in the overweight group [6.40 (5.40-7.80) vs 6.96 (5.69-8.22) and 6.80 (5.90-8.40); P = 0.041)]. Cox regression analysis of the 5-year follow-up data indicated that various BMI groups were not associated with significant differences in 5-year MACCEs; however, male sex was the risk factor for MACCEs (hazard ratio 1.83, 95% confidence interval 1.11-3.04; P = 0.019).

CONCLUSIONS:

The BMI of the patients with diabetes undergoing CABG had no effect on MACCEs. Male sex was the risk factor in these patients.

PMID:
30325425
DOI:
10.1093/icvts/ivy287

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