title: Coronary stenting before coronary artery bypass graft surgery in diabetic patients does not increase the perioperative risk of surgery.
abstract: OBJECTIVE
  A negative relationship between coronary stenting before coronary artery bypass graft (CABG) surgery and the perioperative mortality and morbidity has been shown in diabetic patients. We tried to assess this relationship in a 2-institution database.
  
  
  METHODS
  In the years 2005 and 2006, 1125 of 3311 patients undergoing CABG surgery had diabetes mellitus (33.9%), and 185 (16.4%) of the diabetic patients had at least 1 previous stent. There was no evidence of any clinically significant difference in the preoperative and intraoperative parameters between diabetics with or without previous stents.
  
  
  RESULTS
  Thirty-day mortality (no-stent group, 3.86%; stent group, 1.62%) and postoperative major adverse cardiovascular and cerebrovascular events (MACCEs; mortality, stroke, myocardial infarction, renal failure) (no-stent group, 12.2%; stent group, 5.9%) occurred more often in diabetic patients without coronary stents. Logistic regression for 30-day mortality using possible confounders including preoperative stent showed a significant positive effect of preoperative coronary stenting (OR, 0.157; 95% CI limits, 0.033-0.737). Taking percutaneous coronary intervention out of the calculation model, this positive effect was no longer significant (OR, 0.344; CI, 0.091-1.298). Logistic regression for perioperative MACCE, with as well as without percutaneous coronary intervention as a confounder, also showed a significant positive effect of preoperative coronary stenting (OR, 0.231; 95% CI, 0.091-0.590).
  
  
  CONCLUSIONS
  Coronary stenting before CAGB in diabetic patients does not predispose to a higher perioperative risk regarding mortality and morbidity after CABG surgery.
authors.affiliation: Department of Cardiovascular Surgery, University of Giessen, Germany. andreas.boening@chiru.med.uni-giessen.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Boening
authors.forename: Bernd
authors.initials: B
authors.lastname: Niemann
authors.forename: Alexander
authors.initials: A
authors.lastname: Wiedemann
authors.forename: Peter
authors.initials: P
authors.lastname: Roth
authors.forename: Rolf-Hasso
authors.initials: RH
authors.lastname: Bödeker
authors.forename: Christine
authors.initials: C
authors.lastname: Scheibelhut
authors.forename: Markus
authors.initials: M
authors.lastname: Schönburg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality; D003331:Coronary Vessels; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects