Chowdhury Md Abir Tazim, Joshi Dharmendra, Magdum Munama, Adhikary Dipannita, Saklayen S M G, Alauddin Md, Ranjan Redoy, Adhikary Asit Baran
Department of Cardiothoracic and Vascular Surgery, Evercare Hospital Dhaka, Dhaka, Bangladesh.
Department of Cardiac Surgery, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
Int J Gen Med. 2025 Jan 7;18:65-71. doi: 10.2147/IJGM.S502441. eCollection 2025.
Atherosclerosis is a systemic vascular disease commonly affecting coronary and carotid arteries, particularly in diabetes mellitus (DM). This study assessed the association of DM with significant carotid artery stenosis (CAS) among the coronary artery disease (CAD) population undergoing isolated elective coronary artery bypass graft (CABG) surgery.
A prospective cross-sectional study evaluated 100 Bangladeshi CAD patients who underwent isolated elective CABG from January 2017 to September 2019. Initially, a univariate analysis curtails the risk patterns, followed by a Pearson correlation analysis of significant CAS and glycated haemoglobin (HbA1c).
Although the majority of patients were male, females were higher in the diabetic than non-diabetic group (38.1% vs 15.5%; p=0.01). Overall, ~38% of diabetic patients had significantly higher ≥50% CAS. Further, 28.6% and 9.5% of the diabetic sample had 50-70% and >70% CAS, respectively, which is significantly (p =0.02) higher than the non-diabetic sample (8.6% and 1.7%, respectively). Additionally, diabetes was significantly more associated with both unilateral (31.0% vs 22.4%) and bilateral (45.2% vs 22.4%) CAS than the non-diabetic population (p=0.006). The Pearson correlation coefficient shows a significant positive association between higher glycated haemoglobin levels and >50% CAS (correlation coefficient 0.270; p = 0.007).
We found higher HbA1c had a significant positive correlation with >50% CAS in diabetic patients undergoing elective CABG, recommending preoperative carotid screening, especially elderly individuals.
动脉粥样硬化是一种全身性血管疾病，常见于冠状动脉和颈动脉，尤其是在糖尿病（DM）患者中。本研究评估了在接受单纯择期冠状动脉旁路移植术（CABG）的冠状动脉疾病（CAD）人群中，DM与严重颈动脉狭窄（CAS）之间的关联。
一项前瞻性横断面研究评估了2017年1月至2019年9月期间接受单纯择期CABG的100例孟加拉国CAD患者。首先，单因素分析确定风险模式，随后对严重CAS与糖化血红蛋白（HbA1c）进行Pearson相关性分析。
尽管大多数患者为男性，但糖尿病组中的女性比例高于非糖尿病组（38.1%对15.5%；p=0.01）。总体而言，约38%的糖尿病患者有≥50%的严重CAS。此外，糖尿病样本中分别有28.6%和9.5%的患者有50%-70%和>70%的CAS，显著高于非糖尿病样本（分别为8.6%和1.7%；p=0.02）。此外，与非糖尿病人群相比，糖尿病与单侧（31.0%对22.4%）和双侧（45.2%对22.4%）CAS的相关性显著更高（p=0.006）。Pearson相关系数显示，较高的糖化血红蛋白水平与>50%的CAS之间存在显著正相关（相关系数0.270；p=0.007）。
我们发现，在接受择期CABG的糖尿病患者中，较高的HbA1c与>50%的CAS存在显著正相关，建议进行术前颈动脉筛查,尤其是老年患者。
