Diabetes, Heart and Cardiovascular Diseases News Chronicle. Diabetes, Cardiovascular and Heart Diseases. Article 254
Published on October 10, 2017 at 11:00 AM PM GMT


 



Coronary artery bypass surgery (CABG) is effective in treating atherosclerotic coronary arteries among type 1 diabetes patients

Artery bypass surgery, CABG revascularization is effective in treating atherosclerotic coronary arteries.

A study done by researchers at the Karolinska Institutet, Sweden shows coronary artery bypass grafting (CABG) is the best procedure to treat atherosclerotic coronary arteries in diabetic patients with multivessel disease (even among type 1 diabetes T1D patients). This study confirms the current international guidelines recommending CABG over the balloon catheter (percutaneous coronary intervention, PCI) procedure among those diabetic patients who are with two are more unhealthy or diseased coronary vessels.



In a percutaneous coronary intervention (PCI), surgeons use a balloon catheter (catheter with an inflatable balloon at its tips) to expand or enlarge a narrow artery blood passage. Previously name for this procedure is angioplasty with stent.

Researchers conducted follow up studies among those type 1 diabetes (T1D) patients who underwent a procedure for improving blood circulation in the heart with two or more narrowed coronary vessels (called as revascularization) in Sweden between 1995 and 2013. Their 10-year average follow up study among those patients who undergo revascularization using percutaneous coronary intervention (PCI) procedure when compared to coronary artery bypass surgery (CABG) procedure shows following higher risks with PCI procedure

Health problem Higher risk %
Fatal heart disease 45%
Myocardial infarction 47%
The likely chances for further PCI or CABG treatment are five times


The study also found that the relative number of CAGB procedures among type 1 diabetes (T1D) patients declined from 58 percent (between 1995 and 2000) to 5 percent (between 2007 and 2013) as the percutaneous coronary intervention (PCI) procedure is easier to perform and a non-invasive procedure.

Researchers say their study findings suggest coronary artery bypass grafting (CABG) should also be the preferred procedure for type 1 diabetes (T1D) patients with two or more diseased coronary vessels. The current guidelines too state the same thing.

Researcher of the study was Dr. Martin J Holzmann MD, PhD, the Department of Emergency Medicine, Karolinska Institutet, Solna, Sweden. The study findings were published online on August 26, 2017, in the Journal of the American College of Cardiology (JACC). Title of the article was "Survival After Coronary Artery Bypass Grafting in Patients With Preoperative Heart Failure and Preserved vs Reduced Ejection Fraction."



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CABG : Coronary artery bypass grafting (CABG) procedure will be performed on severe coronary heart disease (CHD) patients (CHD disease due to plaque in the arteries) to improve blood flow to the heart. This procedure requires general anesthesia and takes between three to six hours. The severity of blockages and blockage locations are the criteria for the number of bypass surgeries. Up to six bypass surgeries can be performed at a time.

Care or nursing after CABG procedure was intended to reduce risk factors for heart diseases such as blood pressure (BP), stress and cholesterol levels, stopping tobacco usage, regular exercise and leading a better lifestyle along with medications. Some complications with CABG surgery are

  • Formation of blood clots
  • Between 5 and 10 percent of the patients may experience heart attacks
  • Between 1 and 2 percent of the patients (primarily in elderly or old age patients) may experience a stroke
  • About 5 percent of the patients may require re-exploration procedure due to bleeding (before or after surgery), a risk of lung complications and chest infection.
  • Risk for another operation increases each year, two percent risk after 5 years and seven percent risk after 10 years

 



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