Early outcomes of isolated coronary artery bypass grafting in Chinese aged patients with diabetes mellitus

To compare the early outcomes of coronary artery bypass grafting [CABG] in aged diabetic patients, and evaluate the affection of diabetes on the early outcomes of CABG in aged patients. The study took place in the Department of Cardiovascular Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China, between January 2000 and July 2008. Five hundred and ninety-three elderly patients [age >/= 70-years-old], undergoing isolated CABG were retrospectively divided into diabetic group and non-diabetic group. We analyzed the pre-operative, intra-operative, and post-operative variables of the 2 groups. The t-test, Chi-square test, and multivariate logistic regression were used to determine the differences between the 2 groups of patients. There was no statistical difference of pre-operative and intraoperative variables between the 2 groups, except that there were more left main coronary artery diseases in the diabetic group. Values in the post-operative period such as morbidity, complications, and blood infusion had no differences between the 2 groups. Diabetes mellitus and age are not the risk factors for in-hospital mortality. Coronary artery bypass grafting in elderly patients is plausible. Furthermore, diabetic patients could get the same surgical results as those non-diabetic patients

Significance of changes in transforming growth factor-beta mRNA levels in autogenous vein grafts / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study was designed to investigate changes in mRNA levels of transforming growth factor-beta (TGF-beta), collagen I, and collagen III in autogenous vein grafts.</p><p><b>METHODS</b>Twenty-four New Zealand rabbits were randomly divided into 4 groups with 6 rabbits each. The external jugular veins of the New Zealand rabbits were harvested and grafted into the ipsilateral carotid artery. All rabbits were fed with a standard diet. After the operation, the rabbits were sacrificed at 1, 2, 3, or 4 weeks. TGF-beta, collagen I, and collagen III mRNA levels in the venous grafts were measured by semiquantitative methods at every time point. The contralateral external jugular veins were also harvested and analyzed as controls. Glyceraldehyde-3-phosphate dehydrogenase was used as an internal standard to normalize all samples for potential variations in mRNA content. In order to observe the expression of TGF-beta protein, immunohistochemical SABC methods were used.</p><p><b>RESULTS</b>One week postoperation, the mRNA level of TGF-beta was upregulated to 1.73 +/- 0.19 in the vein graft and 1.21 +/- 0.16 in the control vein (P < 0.01). High mRNA levels were maintained until week 4 postoperation. The mRNA levels of collagen I and collagen III were also significantly increased to 2.18 +/- 0.21 versus 1.12 +/- 0.24 and 1.08 +/- 0.13 versus 0.83 +/- 0.12, respectively (P < 0.05). Immunohistochemical staining revealed a higher density of TGF-beta expression in the vein grafts.</p><p><b>CONCLUSIONS</b>An uninterrupted increase in mRNA levels of TGF-beta, collagen I, and collagen III is observed in autogenous vein grafts. This increase may be the major cause of intimal hyperplasia, sclerosis, and even graft failure.</p>