Our Summary

This study looked at how diabetes affects the long-term survival and quality of life of patients who have undergone coronary artery bypass grafting (CABG), which is a type of heart surgery. The researchers followed 508 patients, about 15% of whom had diabetes, for 12 years after their surgery.

The study found that the survival rate of diabetic patients was lower than that of non-diabetic patients 10 years after surgery. However, both groups saw a significant improvement in their quality of life one year after surgery. This was measured using the RAND-36 Health Survey, which looks at various aspects of physical and mental health.

Over the 12-year follow-up period, the quality of life for both groups declined, but this decline was more significant for diabetic patients. Despite this, both groups maintained at least some improvement in their quality of life over the 12 years.

In summary, while diabetic patients have a lower long-term survival rate after CABG compared to non-diabetic patients, they still experience a similar improvement in quality of life in the first year after surgery. However, their quality of life tends to decline more over time.

FAQs

  1. How does having diabetes affect the long-term survival rate of patients who undergo coronary artery bypass grafting (CABG)?
  2. How does the quality of life for diabetic and non-diabetic patients compare following CABG surgery?
  3. What is the RAND-36 Health Survey and how was it used in this study?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about CABG is to closely monitor and manage their diabetes after surgery. This can help improve their long-term survival rate and quality of life. Patients with diabetes should work with their healthcare team to control their blood sugar levels, maintain a healthy diet, exercise regularly, and take medications as prescribed. By taking proactive steps to manage their diabetes, patients can potentially improve their outcomes after CABG surgery.

Suitable For

Patients who are typically recommended for CABG include those with severe coronary artery disease, particularly those with multiple blockages in the coronary arteries that cannot be effectively treated with medication or less invasive procedures such as angioplasty. Other factors that may indicate the need for CABG include:

  1. Persistent chest pain (angina) that is not relieved by medication or lifestyle changes
  2. Severe narrowing or blockages in the left main coronary artery
  3. Severe narrowing or blockages in multiple coronary arteries
  4. Diabetes, especially if the patient has additional risk factors such as high blood pressure, high cholesterol, or a history of smoking
  5. Previous heart attacks or other complications related to coronary artery disease
  6. Poor heart function, such as reduced ejection fraction
  7. History of failed angioplasty or stent placement
  8. Presence of other medical conditions that increase the risk of complications during surgery

Ultimately, the decision to recommend CABG is based on a thorough evaluation of each patient’s individual medical history, symptoms, and overall health. It is important for patients to discuss their treatment options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before CABG:

  • Patients may experience symptoms of coronary artery disease, such as chest pain, shortness of breath, and fatigue.
  • Patients undergo various tests, such as angiography, to determine the extent of blockages in their coronary arteries.
  • Patients may undergo lifestyle changes, medication therapy, and other interventions to manage their symptoms before surgery.

After CABG:

  • Immediately after surgery, patients will be monitored in the intensive care unit and then moved to a regular hospital room for further recovery.
  • Patients will undergo cardiac rehabilitation to improve their physical strength and overall health.
  • Patients will need to make lifestyle changes, such as quitting smoking, following a heart-healthy diet, and engaging in regular exercise.
  • Patients will need to take medications to manage their heart health, such as blood thinners and cholesterol-lowering drugs.
  • Patients will have regular follow-up appointments with their healthcare providers to monitor their progress and address any concerns.
  • Over time, patients may experience improvements in their symptoms and quality of life, but they will need to continue to manage their heart health to prevent future complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about CABG in relation to diabetes include:

  1. How does having diabetes affect my risk of complications during or after CABG surgery?
  2. What steps can I take to manage my diabetes before and after surgery to improve outcomes?
  3. Will my diabetes impact the long-term success of the surgery in terms of survival rates and quality of life?
  4. What lifestyle changes should I make to support my recovery and improve my overall health as a diabetic patient who has undergone CABG?
  5. Are there any specific medications or follow-up care plans I should consider as a diabetic patient post-CABG surgery?
  6. How often should I have follow-up appointments to monitor my diabetes and overall heart health after CABG surgery?
  7. Are there any warning signs or symptoms I should watch out for as a diabetic patient post-surgery that may indicate a complication or decline in quality of life?
  8. Are there any support groups or resources available for diabetic patients who have undergone CABG surgery to help with recovery and long-term management?

Reference

Authors: Järvinen O, Hokkanen M, Huhtala H. Journal: Int J Angiol. 2019 Mar;28(1):50-56. doi: 10.1055/s-0038-1676791. Epub 2019 Jan 2. PMID: 30880894