Lijecnicki vjesnik 2005;127(6)
ADVANCED MYOCARDIAL ISCHEMIA IN PATIENTS WITH DIABETES MELLITUS – EARLY RESULTS OF SURGICAL TREATMENT
Bojan Štambuk, Željko Sutlić, Bojan Biočina, Igor Rudež, Davor Barić, Daniel Unić, Kristina Brkić
Abstract
Summary. In this restrospetive study, data on 272 coronary artery disease patients with concomitant diabetes mellitus treated between 12/1997 and 12/2002 were analyzed. Eighty patients inderwent complete arterial revascularization (DM-ART), whereas 192 patients underwent coronary revascularization using arterial-venous grafts (DN-NEART). The following preoperative data and risk factors were analyzed: arterial hypertension, hyperlipoproteinemia, number of vessels involved, left coronary artery stenosis, unstable angina, previous myocardial infarction (MI), previous cardiac surgery, EuroScore. During a 30-day postope- rative period, the following complications were analyzed: bleeding, perioperative MI, wound infection, sternal dehiscence, neurologic dysfunction, mortality. DM-ART patients had a higher rate of hyperlipoproteinemia (p=0.004). Difference was only found for the occurrence of perioperative MI in DM-NEART group (p<0.001). Total arterial revascularization without cardiopul- monary bypass is a reliable and safe choice in patients with concomitant diabetes mellitus irrespective of its type. Definitive conclusions can only be made after five- or ten-year evaluation of postoperative mirbidity and mortality.