Does diabetes mellitus increase the mortality risk in coronary artery disease patients undergoing coronary artery bypass grafting surgery at the National Heart Institute of Kuala Lumpur? (original) (raw)

2018, Journal of Diabetes, Metabolic Disorders & Control

Globally, the number of patients with diabetes mellitus (DM) has increased to almost 451 million in 2017 and has become a worldwide epidemic. Even more worrisome is that 49.7% of them remain undiagnosed. 1 Studies have shown that coronary artery disease (CAD) is the principal cause of mortality in DM patients and linked with significantly higher cardiovascular mortality due to myocardial infarction and stroke. 2,3 DM has always been a major risk predictor for unfavourable outcomes in patients undergoing cardiac revascularization either percutaneous coronary intervention (PCI) 4 or coronary artery bypass grafting (CABG), 5,6 surgery. Methods We performed a single-centre retrospective study on the validation of EuroSCORE II among 1718 patients undergoing CABG surgery at the National Heart Institute (IJN) of Kuala Lumpur from 1st January to 31st December 2016. EuroSCORE II is a risk evaluation tool that included ten patient-related factors, five cardiac-related factors, and three operation-related factors with the aim of determining in-hospital mortality after cardiac surgery. Patient-related factors include age (year), gender (male /female), renal impairment (creatinine clearance), extra cardiac arteriopathy, poor mobility, previous cardiac surgery, chronic lung disease, active endocarditic, critical preoperative state and diabetes on insulin. Cardiac-related factors include the New York Heart Association (NYHA) stages, Canadian Cardiovascular Society (CCS) class 4 angina, Left Ventricular (LV) function (ejection fraction >50%, 31-50%, 21-30%, <20%), recent myocardial infarction (MI) (within 90 days) and pulmonary hypertension (31-55mm Hg / >55mm Hg). Operation-related factors include urgency (elective, urgent, emergency, salvage), weight of the intervention (isolated CABG, isolated single non-CABG, 2-procedures, and 3-procedures)