PMID- 10440169
OWN - NLM
STAT- MEDLINE
DCOM- 19990817
LR  - 20220321
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 34
IP  - 2
DP  - 1999 Aug
TI  - Effects of coronary artery bypass grafting using internal mammary arteries for 
      diabetic patients.
PG  - 532-8
AB  - OBJECTIVES: In our institute, internal mammary arteries (IMAs) have been 
      preferred for coronary artery bypass grafting (CABG) in diabetic patients. The 
      purpose of this study was to evaluate the influence of diabetes and IMA grafting 
      on survival after CABG. BACKGROUND: The influence of diabetes on the results of 
      CABG is not well documented, and there is controversy about whether the use of 
      IMAs conveys greater survival benefits to diabetic patients. METHODS: A total of 
      420 consecutive patients who underwent CABG from April 1990 to July 1998 were 
      reviewed; 211 of these patients had diabetes mellitus at the time of surgery. 
      Internal mammary artery grafts have been used with increasing frequency, and 
      bilateral IMAs have been used when possible since 1993. Internal mammary artery 
      grafts were used in 164 nondiabetic patients (78%) and in 155 diabetic patients 
      (73%). Seventy-eight nondiabetic patients and 74 diabetic patients received 
      bilateral IMA grafts. RESULTS: The postoperative mortality was 2.4% in the 
      nondiabetic and 2.8% in the diabetic group. With regard to postoperative 
      complications, diabetic patients had a significantly higher rate of chest wound 
      infection (p < 0.05), irrespective of whether IMAs were used or not. The use of 
      bilateral IMAs did not increase the risk of chest wound infection in nondiabetic 
      or diabetic patients. Overall survival curve, cardiac death-free curve and 
      cardiac event-free curve were not affected adversely by diabetes, and in diabetic 
      patients, CABG with saphenous veins alone conveyed significantly (p < 0.01) less 
      long-term benefit than did CABG with at least one IMA graft. CONCLUSIONS: It was 
      suggested that IMA grafts should be preferred in diabetic patients.
FAU - Hirotani, T
AU  - Hirotani T
AD  - Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital, Japan.
FAU - Kameda, T
AU  - Kameda T
FAU - Kumamoto, T
AU  - Kumamoto T
FAU - Shirota, S
AU  - Shirota S
FAU - Yamano, M
AU  - Yamano M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass/adverse effects/*methods/mortality
MH  - Coronary Disease/complications/surgery
MH  - *Diabetes Complications
MH  - Female
MH  - Humans
MH  - Male
MH  - Mammary Arteries/*transplantation
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Surgical Wound Infection
MH  - Survival Rate
EDAT- 1999/08/10 00:00
MHDA- 1999/08/10 00:01
CRDT- 1999/08/10 00:00
PHST- 1999/08/10 00:00 [pubmed]
PHST- 1999/08/10 00:01 [medline]
PHST- 1999/08/10 00:00 [entrez]
AID - S0735-1097(99)00215-6 [pii]
AID - 10.1016/s0735-1097(99)00215-6 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1999 Aug;34(2):532-8. doi: 10.1016/s0735-1097(99)00215-6.