Herlitz J, Wognsen G B, Emanuelsson H, Haglid M, Karlson B W, Karlsson T, Albertsson P, Westberg S
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Diabetes Care. 1996 Jul;19(7):698-703. doi: 10.2337/diacare.19.7.698.
To describe mortality and morbidity during a 2-year period after coronary artery bypass grafting (CABG) among diabetic and nondiabetic patients.
All the patients in western Sweden in whom CABG was undertaken between June 1988 and June 1991 and in whom concomitant procedures were not performed were registered prospectively. The study was a prospective follow-up.
Diabetic patients (n = 268) differed from nondiabetic patients (n = 1,859) in that more women were included, and the patients more frequently had a previous history of myocardial infarction (MI), hypertension, congestive heart failure, intermittent claudication, and obesity. Diabetic patients more frequently required reoperation and had a higher incidence of peri- and postoperative neurological complications. Mortality during the 30 days after CABG was 6.7% in diabetic patients versus 3.0% in nondiabetic patients (P < 0.01). Mortality between day 30 and 2 years was 7.8 and 3.6%, respectively (P < 0.01). During 2 years of follow-up, a history of diabetes appeared to be a significant independent predictor of death. Whereas the development of MI after discharge from the hospital did not significantly differ between the two groups; 6.3% of diabetic patients developed stroke versus 2.5% in nondiabetic patients (P < 0.001).
Diabetic patients have a mortality rate during the 2-year period after CABG that is about twice that of nondiabetic patients during both the early and late phase after the operation.
描述糖尿病患者和非糖尿病患者冠状动脉旁路移植术(CABG)后2年期间的死亡率和发病率。
前瞻性登记了1988年6月至1991年6月期间在瑞典西部接受CABG且未进行同期手术的所有患者。该研究为前瞻性随访研究。
糖尿病患者(n = 268)与非糖尿病患者(n = 1859)不同,纳入的女性更多,且患者更常有心肌梗死(MI)、高血压、充血性心力衰竭、间歇性跛行和肥胖病史。糖尿病患者更常需要再次手术,围手术期和术后神经系统并发症的发生率更高。CABG后30天内糖尿病患者的死亡率为6.7%,而非糖尿病患者为3.0%(P < 0.01)。30天至2年期间的死亡率分别为7.8%和3.6%(P < 0.01)。在2年的随访期间,糖尿病病史似乎是死亡的重要独立预测因素。两组出院后MI的发生率无显著差异;6.3%的糖尿病患者发生中风,而非糖尿病患者为2.5%(P < 0.001)。
糖尿病患者在CABG后2年期间的死亡率在术后早期和晚期均约为非糖尿病患者的两倍。