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Abstract
The article evaluates the effectiveness of coronary artery bypass grafting (CABG) in patients with diabetes mellitus (DM), highlighting its benefits and complications. DM is a metabolic disorder associated with significant cardiovascular complications, such as diabetic cardiomyopathy, which impairs cardiac function and increases mortality risk. CABG is widely used in the treatment of complex coronary artery disease (CAD) and is indicated in cases of multi-vessel obstructions or involvement of the left main coronary artery.
Through a systematic review, the study analyzed the outcomes of diabetic patients undergoing CABG, focusing on clinical results, mortality, and quality of life. The findings revealed that CABG provides significant benefits, such as reduced mortality and a lower need for future revascularizations, especially in patients with advanced CAD. Additionally, the surgery was shown to be superior to percutaneous coronary intervention in terms of protection against recurrent cardiac events, such as myocardial infarction.
However, CABG in diabetic patients is associated with higher rates of postoperative complications, such as deep wound infections, acute kidney injury, and prolonged invasive ventilation. These risks were particularly elevated in patients with poor glycemic control, as evidenced by high levels of glycated hemoglobin (HbA1c). The study emphasized that diabetic patients with optimized metabolic control had better outcomes and a lower incidence of complications, reinforcing the importance of effective glycemic management in the preoperative period.
Although advanced age, comorbidities, and insulin use were also associated with higher complication risks, the overall results indicate that CABG remains an effective option for diabetic patients with complex CAD. The article concludes that the success of CABG in diabetic patients depends on strict metabolic control and highlights the need for personalized clinical management to minimize risks and optimize the procedure’s benefits.
References
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Copyright (c) 2024 Bianca Cajé Nunes, Isabelle Ebert Marino, Maria Claudia Albuquerque Castelo Branco, Andreza Werli, Livia Soares e Melo, Anderson dos Santos Pereira, Kleber Raphael Guimarães Ramalho, Elaine da Silva Chales, Diogo Ibargoyen Rech, Maria Beatriz Magalhães, Jade Ananda Ribeiro, Arillany da Silva Mendes Cortes, Gabriel Antonio Lemos Torres, Lúcio Mauro Boaventura Latorre, Beatriz Maria Andreoli Fellini