Abstract:
This study aimed to examine the influence of diabetes on the left internal mammary artery (LIMA) and saphenous vein (SV) graft failure for 5-year follow-up. We enrolled 202 patients who underwent isolated off-pump coronary artery bypass grafting (CABG) surgery in 2014, angiographic follow-up occurred at 5 years after surgery. Angiographic outcomes in patients with or without diabetes were analyzed. Multivariate logistic regression analysis was used to identify independent predictors of graft dysfunction. A total of 66 (32.7%) patients had diabetes. Five-year rates of LIMA and SV graft failure were similar in patients with and without diabetes. In addition, in diabetics, the proportion of complete graft failure was significantly lower in the LIMA grafts (12/66, 18.2%) than in the SV grafts (57/133, 42.9%) (P = .001). In nondiabetic, the proportion of complete graft failure was also significantly lower in the LIMA grafts (28/136, 20.6%) than in the SV grafts (105/275, 38.2%) (P < .001). Multivariate logistic regression analysis showed that mean graft flow (MGF) was an independent predictor factor for LIMA (odds ratio = 1.186, 95% CI = 1.114-1.263, P < .001) and SV (odds ratio = 1.056, 95% CI = 1.035-1.077, P < .001) graft failure. Diabetes did not influence the patency of LIMA or SV grafts over a 5-year follow-up. LIMA grafts should be maximized in patients undergoing off-pump CABG surgery. Diabetes does not affect the patency of grafts CABG. Using angiography, our study proved that diabetes does not affect the patency of grafted vessels after CABG for 5 years.
摘要:
这项研究旨在研究糖尿病对左乳内动脉(LIMA)和隐静脉(SV)移植失败的影响,为期5年。我们在2014年纳入了202例接受孤立性非体外循环冠状动脉旁路移植术(CABG)手术的患者,术后5年进行了血管造影随访。分析有或没有糖尿病患者的血管造影结果。多因素logistic回归分析用于确定移植物功能障碍的独立预测因子。共有66例(32.7%)患者患有糖尿病。在有和没有糖尿病的患者中,LIMA和SV移植物衰竭的五年发生率相似。此外,在糖尿病患者中,LIMA移植物中完全移植失败的比例(12/66,18.2%)显著低于SV移植物(57/133,42.9%)(P=.001).在非糖尿病患者中,LIMA移植物完全移植失败的比例(28/136,20.6%)也显著低于SV移植物(105/275,38.2%)(P<.001).多因素Logistic回归分析显示,平均移植物流量(MGF)是LIMA(比值比=1.186,95%CI=1.114-1.263,P<.001)和SV(比值比=1.056,95%CI=1.035-1.077,P<.001)移植失败的独立预测因素。在5年的随访中,糖尿病不会影响LIMA或SV移植物的通畅性。在接受非体外循环CABG手术的患者中,应最大化LIMA移植物。糖尿病不影响CABG移植物的通畅性。用血管造影,我们的研究证明糖尿病不影响CABG术后5年移植血管的通畅性.