The Role of Insulin Resistance in the Development of Complications after Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease.

Autor:	Sumin AN; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Bezdenezhnykh NA; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Bezdenezhnykh AV; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Osokina AV; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Kuzmina AA; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Sinitskaya AV; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia., Barbarash OL; Federal State Budgetary Institution 'Research Institute for Complex Issues of Cardiovascular Diseases', Sosnovy Blvd. 6, Kemerovo 650002, Russia.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2023 Nov 05; Vol. 11 (11). Date of Electronic Publication: 2023 Nov 05.
DOI:	10.3390/biomedicines11112977
Abstrakt:	The aim of the study was to investigate the effect of carbohydrate metabolism disorders and insulin resistance indices on the immediate results of coronary artery bypass grafting (CABG). Method: Patients with coronary artery disease who underwent CABG ( n = 383) were examined to determine glycemic status, free fatty acid and fasting insulin levels, and insulin resistance indices (Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), McAuley index, Quantitative Insulin Sensitivity Check Index (QUICKI), Revised-QUICKI). Patients were assessed for the development of perioperative complications and their length of stay in the hospital. Two groups were formed: group 1, patients with a combined endpoint (CEP, any complication and/or duration of hospital stay >10 days), n = 291; and group 2 ( n = 92) without a CEP. Perioperative characteristics were analyzed, and predictors of hospital complications and prolonged hospital stay were evaluated. Results: Patients in the CEP group were older, and there were more women among them ( p = 0.003). Additionally, in this group, there were more patients with diabetes mellitus (37.5% vs 17.4%, p < 0.001), obesity ( p < 0.001), and a higher percentage of combined operations ( p = 0.007). In the group with a CEP, the levels of glucose ( p = 0.031), glycated hemoglobin ( p = 0.009), and free fatty acids ( p = 0.007) and the Revised-QUICKI ( p = 0.020) were higher than in the group without complications. In a regression analysis, the independent predictors of complications were combined operations ( p = 0.016) and the predictors of a long hospital stay (>14 days) were female gender, the left atrium size, and diabetes mellitus ( p < 0.001). The predictors of a composite endpoint included female gender, age, the left atrium size, and free fatty acid levels ( p < 0.001). Conclusions: In the group with in-hospital complications after CABG, not only was the presence of diabetes mellitus more often detected, but there were also higher levels of free fatty acids and a higher Revised-QUICKI. Therefore, additional assessments of insulin resistance and free fatty acid levels are advisable in patients before CABG.
Databáze:	MEDLINE
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