METHODS: A retrospective propensity score matched (PSM) analysis of 1370 patients who underwent bypass surgery for ACS between June 2011 and October 2019 was conducted. All patients were divided into two groups: non-diabetic group (n = 905) and diabetic group (n = 465). In-hospital mortality was the primary outcome. Secondary outcomes were perioperative myocardial infarction, new onset dialysis, reopening for bleeding and duration of intensive care unit (ICU) stay. A subgroup analysis of patients with insulin-dependent and non-insulin dependent DM was also performed.
RESULTS: After performing PSM analysis, baseline characteristics and the preoperative risk profile were comparable between both groups. The proportion of patients who underwent total arterial revascularization (p = .048) with the use of both internal thoracic arteries (p < .001) was significantly higher in the non-diabetic group. The incidence of perioperative myocardial infarction (p = .048) and new onset dialysis (p = .008) was significantly higher in the diabetic group. In-hospital mortality was statistically (p = .907) comparable between the two groups.
CONCLUSIONS: DM was associated with a higher incidence of adverse outcomes, however with comparable in-hospital mortality in patients who underwent CABG procedure for ACS.
方法:对2011年6月至2019年10月期间接受了ACS搭桥手术的1370例患者进行了回顾性倾向评分匹配(PSM)分析。将所有患者分为两组:非糖尿病组(n=905)和糖尿病组(n=465)。住院死亡率是主要结果。次要结果是围手术期心肌梗死,新开始的透析,重新开放出血和重症监护病房(ICU)住院时间。还对胰岛素依赖性和非胰岛素依赖性DM患者进行了亚组分析。
结果:执行PSM分析后,两组的基线特征和术前风险状况具有可比性.在非糖尿病组中,使用两个胸廓内动脉(p<.001)进行全动脉血运重建(p=.048)的患者比例明显更高。糖尿病组的围手术期心肌梗死(p=0.048)和新发透析(p=0.008)的发生率明显较高。两组的住院死亡率具有统计学可比性(p=0.907)。
结论:DM与较高的不良结局发生率相关,然而,在接受CABG手术的ACS患者中,院内死亡率相当。