The influence of diabetes and hypertension on the results of coronary revascularization
| Autor: | Pasternack Bs, Isom Ow, Bhat Jg, Ephraim Glassman, Arthur D. Boyd, George E. Reed, Richard M. Engelman, Frank C. Spencer |
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| Rok vydání: | 1976 |
| Předmět: |
Cardiac output
medicine.medical_specialty Remission Spontaneous Myocardial Infarction Shock Cardiogenic Coronary Disease Angina Pectoris Diabetes Complications Internal medicine Diabetes mellitus Occlusion Medicine Humans Adverse effect business.industry Incidence (epidemiology) Angiocardiography Arrhythmias Cardiac General Medicine Acute Kidney Injury medicine.disease Coronary revascularization Coronary arteries medicine.anatomical_structure Infarction Cerebrovascular Circulation Hypertension Mammary artery Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American journal of the medical sciences. 271(1) |
| ISSN: | 0002-9629 |
| Popis: | The effects of diabetes and hypertension on the early postoperative course of patients undergoing coronary revascularization were studied by reviewing the records of 177 patients operated upon in 1972. There were 121 nondiabetic, nonhypertensive; 32 hypertensive; ten diabetic; and 14 diabetic-hypertensive patients. The incidence of postoperative low cardiac output, renal insufficiency and arrhythmia was significantly higher in the hypertensive patient. Operative mortality ranged from 0 in diabetic patients, to 0.8 per cent in nondiabetic, nonhypertensives, to 7.1 per cent in diabetic-hypertensives and 12.5 per cent in hypertensive patients, suggesting an increased risk for the hypertensive patient. The one- to two-year follow-up results documented symptomatic improvement in 90.7 per cent of patients with little adverse effect apparent from diabetes or hypertension. Pre- and postoperative coronary angiography was carried out in 103 patients between 1968 and 1973 with a mean elapsed time between operation and postoperative angiogram of 9.3 months. The progression of atherosclerosis was graded on a 0-4 basis in both grafted and ungrafted coronary arteries. While hypertension appeared to contribute to disease progression, the incidence of vein graft and internal mammary artery bypass occlusion was not significantly affected by either diabetes or hypertension. This study has shown that while hypertension contributes to increased morbidity and mortality in the early postoperative period and an increased rate of progression of atherosclerosis, neither diabetes nor hypertension appeared to influence the one- to two-year results of coronary revascularization. |
| Databáze: | OpenAIRE |
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