Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2024 Aug 2;103(31):e39178. doi: 10.1097/MD.0000000000039178.
This study aimed to examine the influence of diabetes on the left internal mammary artery (LIMA) and saphenous vein (SV) graft failure for 5-year follow-up. We enrolled 202 patients who underwent isolated off-pump coronary artery bypass grafting (CABG) surgery in 2014, angiographic follow-up occurred at 5 years after surgery. Angiographic outcomes in patients with or without diabetes were analyzed. Multivariate logistic regression analysis was used to identify independent predictors of graft dysfunction. A total of 66 (32.7%) patients had diabetes. Five-year rates of LIMA and SV graft failure were similar in patients with and without diabetes. In addition, in diabetics, the proportion of complete graft failure was significantly lower in the LIMA grafts (12/66, 18.2%) than in the SV grafts (57/133, 42.9%) (P = .001). In nondiabetic, the proportion of complete graft failure was also significantly lower in the LIMA grafts (28/136, 20.6%) than in the SV grafts (105/275, 38.2%) (P < .001). Multivariate logistic regression analysis showed that mean graft flow (MGF) was an independent predictor factor for LIMA (odds ratio = 1.186, 95% CI = 1.114-1.263, P < .001) and SV (odds ratio = 1.056, 95% CI = 1.035-1.077, P < .001) graft failure. Diabetes did not influence the patency of LIMA or SV grafts over a 5-year follow-up. LIMA grafts should be maximized in patients undergoing off-pump CABG surgery. Diabetes does not affect the patency of grafts CABG. Using angiography, our study proved that diabetes does not affect the patency of grafted vessels after CABG for 5 years.
本研究旨在探讨糖尿病对左内乳动脉（LIMA）和隐静脉（SV）桥接失败的影响，随访时间为 5 年。我们纳入了 2014 年接受单纯非体外循环冠状动脉旁路移植术（CABG）的 202 例患者，术后 5 年进行血管造影随访。分析了有糖尿病和无糖尿病患者的血管造影结果。采用多变量逻辑回归分析确定桥接功能障碍的独立预测因子。共有 66 例（32.7%）患者患有糖尿病。有糖尿病和无糖尿病患者的 LIMA 和 SV 桥接失败的 5 年发生率相似。此外，在糖尿病患者中，LIMA 桥接完全失败的比例明显低于 SV 桥接（12/66，18.2%）比（57/133，42.9%）（P=0.001）。在非糖尿病患者中，LIMA 桥接完全失败的比例也明显低于 SV 桥接（28/136，20.6%）比（105/275，38.2%）（P<0.001）。多变量逻辑回归分析显示，平均桥接流量（MGF）是 LIMA（比值比=1.186，95%可信区间=1.114-1.263，P<0.001）和 SV（比值比=1.056，95%可信区间=1.035-1.077，P<0.001）桥接失败的独立预测因素。糖尿病在 5 年随访期间不影响 LIMA 或 SV 桥接的通畅性。在接受非体外循环 CABG 手术的患者中，应最大限度地使用 LIMA 桥接。糖尿病不影响桥接的通畅性。本研究通过血管造影证实，糖尿病不影响 CABG 术后 5 年移植物血管的通畅性。
