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Increased early postoperative morbidity with off-pump coronary artery bypass grafting surgery in patients with diabetes.
Can J Cardiol. 2004 Dec; 20(14):1461-5.CJ

Abstract

BACKGROUND

Patients with diabetes constitute a high-risk population for myocardial revascularization due to extensive coronary disease.

OBJECTIVE

To compare the early postoperative outcomes of patients with diabetes undergoing off-pump or on-pump coronary artery bypass surgery.

METHODS AND RESULTS

Over a four-year period (1995 to 1998), 885 diabetics were operated for primary isolated coronary bypass; 156 patients had off-pump and 729 had on-pump coronary artery bypass surgery. Patients in the off-pump group were significantly older, had a higher incidence of hypertension and renal failure, and received fewer distal anastomoses (2.7 versus 2.9, P=0.004). Postoperative myocardial infarction, reintubation and postoperative use of intra-aortic balloon pump occurred significantly more frequently in the off-pump group (10.3% versus 5.5%, P=0.04; 8.3% versus 3.6%, P=0.03; 7.7% versus 1.5%, P=0.0001, respectively). Multivariate analysis revealed that type of surgery was an independent predictor of these complications, which occurred 1.9, 2.7 and 7.9 times more often, respectively, in the off-pump group. The 30-day mortality rate was not significantly different between the groups.

CONCLUSIONS

Off-pump coronary artery bypass surgery is associated with an increased early postoperative morbidity in patients with diabetes and, thus, should be used with caution.

Authors+Show Affiliations

Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15614342

Citation

Vermes, Emmanuelle, et al. "Increased Early Postoperative Morbidity With Off-pump Coronary Artery Bypass Grafting Surgery in Patients With Diabetes." The Canadian Journal of Cardiology, vol. 20, no. 14, 2004, pp. 1461-5.
Vermes E, Demaria RG, Martineau R, et al. Increased early postoperative morbidity with off-pump coronary artery bypass grafting surgery in patients with diabetes. Can J Cardiol. 2004;20(14):1461-5.
Vermes, E., Demaria, R. G., Martineau, R., Cartier, R., Pellerin, M., Hébert, Y., Bouchard, D., Pagé, P., Carrier, M., & Perrault, L. P. (2004). Increased early postoperative morbidity with off-pump coronary artery bypass grafting surgery in patients with diabetes. The Canadian Journal of Cardiology, 20(14), 1461-5.
Vermes E, et al. Increased Early Postoperative Morbidity With Off-pump Coronary Artery Bypass Grafting Surgery in Patients With Diabetes. Can J Cardiol. 2004;20(14):1461-5. PubMed PMID: 15614342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased early postoperative morbidity with off-pump coronary artery bypass grafting surgery in patients with diabetes. AU - Vermes,Emmanuelle, AU - Demaria,Roland G, AU - Martineau,Raymond, AU - Cartier,Raymond, AU - Pellerin,Michel, AU - Hébert,Yves, AU - Bouchard,Denis, AU - Pagé,Pierre, AU - Carrier,Michel, AU - Perrault,Louis P, PY - 2004/12/23/pubmed PY - 2005/1/28/medline PY - 2004/12/23/entrez SP - 1461 EP - 5 JF - The Canadian journal of cardiology JO - Can J Cardiol VL - 20 IS - 14 N2 - BACKGROUND: Patients with diabetes constitute a high-risk population for myocardial revascularization due to extensive coronary disease. OBJECTIVE: To compare the early postoperative outcomes of patients with diabetes undergoing off-pump or on-pump coronary artery bypass surgery. METHODS AND RESULTS: Over a four-year period (1995 to 1998), 885 diabetics were operated for primary isolated coronary bypass; 156 patients had off-pump and 729 had on-pump coronary artery bypass surgery. Patients in the off-pump group were significantly older, had a higher incidence of hypertension and renal failure, and received fewer distal anastomoses (2.7 versus 2.9, P=0.004). Postoperative myocardial infarction, reintubation and postoperative use of intra-aortic balloon pump occurred significantly more frequently in the off-pump group (10.3% versus 5.5%, P=0.04; 8.3% versus 3.6%, P=0.03; 7.7% versus 1.5%, P=0.0001, respectively). Multivariate analysis revealed that type of surgery was an independent predictor of these complications, which occurred 1.9, 2.7 and 7.9 times more often, respectively, in the off-pump group. The 30-day mortality rate was not significantly different between the groups. CONCLUSIONS: Off-pump coronary artery bypass surgery is associated with an increased early postoperative morbidity in patients with diabetes and, thus, should be used with caution. SN - 0828-282X UR - https://www.unboundmedicine.com/medline/citation/15614342/Increased_early_postoperative_morbidity_with_off_pump_coronary_artery_bypass_grafting_surgery_in_patients_with_diabetes_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -