الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Many studies have focused on the effect of diabetes on CABG outcome. For long term outcomes, diabetes is well documented to be a prognosis factor for increased rates of mortality, following CABG. Studies comparing morbidities and mortality in diabetic and nondiabetic patients undergoing CABG found that diabetic patients presented with more cardiovascular comorbidities preoperatively.261-266 These comorbidities include older age, more extensive coronary artery disease, lower preoperative ejection fraction, higher incidence of hypertension, LVH, cerebrovascular disease, COPD, previous MI, NYHA class III-IV, and heart failure at the time of presentation. Data in these studies found that diabetic patients had lower than 10-year survival following CABG possibly as a result of the underlying pathophysiology of diabetic heart disease.
Other research focused on the gender differences in morbidity and mortality in patients undergoing CABG.267-282 When compared to males, females present at a more symptomatic and acute stage of their disease. They also present at an older age (10 to 15 years later), are more likely to undergo emergent operations, and generally have a higher incidence of DM and cardiovascular complications. Moreover, females often present with MI as the initial presentation of the disease, and is more often fatal.282-284 Additionally, females characteristically have smaller coronary artery size, fewer bypass grafts, and underutilization of the LIMA. These characteristics possibly increase in females the risk for postoperative angina and overall decrease the long term success of the bypass.284
The study included forty diabetic patients, twenty males and twenty females, admitted to Cardiothoracic Surgery Department, University of Alexandria and were scheduled for CABG with post-operative short term monitoring.
CABG operation was done according to the standard on-pump protocol using cardio-pulmonary bypass. Patients were followed up in the immediate post-operative period at one month, two months and three months postoperatively to assess the difference in outcome, as regards to their clinical status, presence of complications.
Patients were divided into two groups according to their gender and the results were compared.
Our results summarized that:
- There were no statistical significant differences between the two studied groups regarding age.
- There were statistical significant differences between the two studied groups regarding height. Males have higher statistical values than females.
- There were no statistical significant differences between the two studied groups regarding BMI.
- There were no statistical significant differences between males and females regarding ALT and AST.
- There were no statistical significant differences between males and females regarding serum creatinine, BUN, fasting blood glucose and Hb.
- Regarding risk factors: there were no statistical significant differences between males and females regarding hypertension, hypercholestermia, left ventricular hypertrophy and obesity, while there were statistical significant differences between males and females regarding tobacco history.
- Wall motion abnormality was found in 4 males (57.1%) and 3 females (42.9%) patients, there were no statistical significant differences between the two studied groups regarding wall motion abnormality.
- Pericardial collection found in 3 males (50.0%) and 3 females (50.0%) patients, there were no statistical significant differences between the two studied groups regarding pericardial collection.
- Ejection fraction ranged between 49.0-60.0 and 49.0-60.0 with a mean of 54.303.812 and 54.103.50 for males and females respectively. There were no statistical significant differences between the two studied groups regarding ejection fraction.