Patients with diabetes have a much higher risk of complications following coronary artery bypass surgery compared with those without diabetes, according to a study published in Asian Cardiovascular & Thoracic Annals.
“European System for Cardiac Operative Risk Evaluation II incorporates insulin-controlled diabetes whilst omitting tablet-controlled diabetes. Differences in adverse clinical outcomes following coronary artery bypass graft (CABG) between these groups are poorly established,” the researchers wrote.
They conducted a comparison of short- and longer-term mortality and morbidity in insulin-controlled diabetes, tablet-controlled diabetes, and patients without diabetes. They assessed isolated first-time CABG urgeries of 8,241 patients (23.5% diabetics and 76.5% non-diabetics) between April 1999 and April 2017.
According to the results, patients with insulin-controlled diabetes had appreciably higher in-hospital mortality, multisystem failure, sternal wound infections, respiratory complications, new dialysis, and longer hospital stays juxtaposed to patients without diabetes. Similarly, they observed worse complications in patients with tablet-controlled diabetes compared to patients without diabetes, as this group had notably higher strokes, superficial sternal wound infections, respiratory complications, new dialysis, postoperative atrial fibrillation, and readmission with myocardial infarction.
“Diabetic treatment subgroups are an independent risk factor for sternal wound infection, new dialysis requirement, multisystem failure, and readmission with myocardial infarction after isolated first CABG surgery,” the researchers concluded. “The findings suggest the need for better risk stratification of diabetic groups prior to cardiac surgery and for improved cardiovascular risk management post-surgery in [patients with] tablet-controlled diabetes.”