Author/Editor		Geršak, Borut; Gračner, Rajko; Brecelj, Aleš; Kirbiš, Janez; Jaklič, Ladislav; Klokočovnik, Tomislav; Kneževič, Ivan; Lakič, Nikola; Kovačič, Nace; Jelenc, Matija; Gabrijelčič, Tone
Title		Primerjava rezultatov bolnikov, operiranih zaradi ishemične bolezni srca s sladkorno boleznijo in brez nje
Translated title		Results of surgical treatment for ishemic heart disease in combination with diabetes
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 3, št. 1
Publication year		2006
Volume		str. 30-5
Language		slo
Abstract		A comparison of the results of surgical treatment for ischemic heart disease in patients with or without diabetes is presented, along with results for additional surgery on one or several heart valves. During the period between the years 1988 and 2005, 5.351 patients were operated on for ischemic heart disease with or without heart valve surgery. Isolated coronary bypass was performed in 4.091 patients (3.067 without diabetes and 1024 with diabetes), and combined surgery involving the valves was done in 1260 patients (898 patients without diabetes, 362 patients with diabetes). In the group of patients with diabetes, there were significantly more women (18.3% vs. 26.4%) and patients who have had a myocardial infarction (58.3% vs. 62.1%), and significantly fewer patients with PTCA (8.0% vs. 8.8%) and after complications of PTCA (0.1% vs.1.1%). The percentage of operated women increased every year, and so did the percentage of patients with poor left ventricular function, diabetes and mitrat valve repair. The average age of operated patients also increases every year, irrespective of their sex and other preoperative characteristics. In the group of patients with diabetes, there were significantly more complications:. mediastinitis (1.4 vs. 0.4%), sternal dehiscences (2.7 vs.1.3%) and heart rhythm disturbances (28.3 vs. 23.4%). The mortality of all patients who were operated on for isolated ischemic heart disease did not differ significantly between the groups with or without diabetes (with diabetes it was 5.4%, without it 4.8%; p = 0.486). The mortality of patients with concurrent heart valve surgery was borderline significant (16 vs. 11.9%, p = 0.051). The mortality of patients with isolated ischemic heart disease, stable angina pectoris and good left ventricular function was low in both groups of patients (with diabetes it was 2.2%, without it 1.9%).
Summary		Predstavljamo primerjavo rezultatov kirurškega zdravljenja ishemične bolezni srca pri bolnikih s sladkorno boleznijo in brez nje ter rezultate ob prisotnosti dodatnih posegov na eni ali več zaklopkah. V obdobju med letoma 1988 in 2005 smo zaradi ishemične bolezni srca s posegi na zaklopkah ali brez njih operirali 5.351 bolnikov. Izolirane koronarne premostitve smo opravili pri 4.091 bolnikih (3.067 bolnikov brez sladkorne bolezni, 1024 s sladkorno boleznijo), kombinirane operacije z zaklopkami pa pri 1260 bolnikih (898 bolnikov brez sladkorne bolezni, 362 s sladkorno boleznijo). V skupini bolnikov s sladkorno boleznijo je bilo pomembno več žensk (18,3% proti 26,4%) in bolnikov s prebolelim srčnim infarktom (58,3% proti 62,1%), pomembno manj pa bolnikov s PTCA (8,0% proti 8,8%) in po zapletih po PTCA (0,1% proti 1,1%). Delež operiranih žensk se je iz leta v leto večal, prav tako se je večal delež bolnikov s slabo funkcijo levega prekata, s sladkorno boleznijo in s popravo mitralne zaklopke. Iz leta v leto se tudi povečuje povprečna starost operiranih bolnikov, ne glede na spol in ostale predoperativne značilnosti. V skupini bolnikov s sladkorno boleznijo je bilo značilno več zapletov: mediastinitis (1,4 proti 0,4%), dehiscence sternuma (2,7 proti 1,3%) in motnje ritma (28,3 proti 23,4%). Umrljivost vseh bolnikov, operiranih zaradi izolirane ishemične bolezni srca, se med skupinama s sladkorno boleznijo in brez nje ne razlikuje pomembno (s sladkorno boleznijo 5,4%, brez nje 4,8%; p = 0,486). Umrljivost bolnikov s sočasno operacijo na zaktopkah je mejno značilna (16% proti 11,9%, p = 0,051). Umrljivost bolnikov z izolirano ishemično boleznijo srca, stabilno angino pektoris in dobro funkcijo levega prekata pa je nizka pri obeh skupinah bolnikov (s sladkorno boleznijo 2,2%, brez nje 1,9%).
Descriptors		CORONARY DISEASE DIABETES MELLITUS ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY CORONARY ARTERY BYPASS HEART VALVE DISEASES TREATMENT OUTCOME