Outcomes of coronary artery bypass grafting in patients under 45 years old with coronary artery disease combined insulin-treated diabetes mellitus / 中华胸心血管外科杂志

ABSTRACT

Objective To investigate the outcomes of coronary artery bypass grafting(CABG) in insulin-treated diabetes mellitus(DM) patients with coronary artery disease(CAD) (age≤45 years old),and analyze the risk factors of major adverse cardiac and cerebrovascular events(MACCE) by logistic regression.Methods Data on 239 CAD patients combined with DM aged ≤45 who underwent CABG in our hospital were collected retrospectively from October 2007 to October 2016.There were 216 males and 23 females,the mean age was (42.15 ±2.59) years old.The mean LVEF was 0.59 ±0.09.43 patients (18.0％) had left main stenosis,and the average diseased vessel number was 3.20 ± 0.76.Results One patients (0.4％)in-hospital died of heart failure.Patients received (3.12 ±0.81) bypass grafts overall,12 patients (5.0％) were total artery revascularization.3 patients (1.3％) needed reoperation for bleeding and the perioperative atrial fibrillation rate was occured in 23 patients (9.6％).The follow-up rate was 95％ (226 cases),the median follow-up time was 5 years (1-9 years).8 patients (3.3％) died of all cause-mortality,and 183 patients (81.0％) were freedom from MACCE.The higher level of BMI、cholesterol and creatinine,LVEF ≤0.35,postoperative blood loss ≥ 1 000 ml and ventricular arrhythmia were the independent risk factors of MACCE.Conclusion CABG procedure in CAD patients under 45 years old accompanied DM is safety and reliable both in early and long-term outcomes.