The SA Journal Diabetes & Vascular Disease Volume 21 No 1 (November 2024)

RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE 6 VOLUME 21 NUMBER 1 • November 2024 cholesterol could not be analysed due to incomplete data sets. All other clinical parameters were comparable between groups (p > 0.05). The pre-operative CK-MB isoform, total cholesterol and NT-proBNP values exceeded the upper reference limit in group 2 (Table 2). The mean EuroSCORE II of both groups was high, but patients were evenly distributed in the three severity classifications with no differences between groups. The intra-operative clinical variables were similar between groups and no significant differences were detected (Table 3). The post-operative outcomes between groups were similar with no significant differences (Table 4). Most patients in both groups had an ICU stay of less than three days, with only 21.43% in group 1 and 14.75% in group 2 exceeding a three-day ICU stay. The mortality rate was low, with only one (2%) fatality in the abnormal CIMT group due to sepsis. Postoperative complications in both groups were limited. Patients with an abnormal CIMT tended to have more postoperative complications than those with a normal CIMT (34.4 vs 21.4%) (Fig. 1). The prevalence of postoperative complications was too low to analyse statistically. When a higher CIMT cut-off value was used as an abnormal indicator for CIMT (0.09 cm), the pre-, intra- and postoperative limited sub-analysis demonstrated similar results between groups with no statistically significant differences (Table 5). Postoperative complications did not show any significant differences. Table 1. Demographic and anthropometric data of normal and abnormal CIMT groups Group 1 Group 2 normal CIMT abnormal CIMT Variables (n = 28, 31%) (n = 61, 69%) p-value Age (years), mean ± SD 58.9 ± 8.88 59.6 ± 9.15 0.72 Gender, n (%) Male 23 (82.1) 54 (88.5) Female 5 (17.9) 7 (11.5) Ethnicity, n (%) Caucasian (n = 69) 22 (78.57) 47 (77.05) > 0.99 Mixed race (n = 9) 2 (7.14) 7 (11.48) 0.71 Black African (n = 9) 4 (14.29) 5 (8.20) 0.45 Asian (n = 2) 0 2 (3.28) – BMI (kg/m2), mean ± SD 26.6 ± 4.88 29.2 ± 5.85 0.03* Overweight, n (%) 12 (42.9) 19 (31.2) Obese, n (%) 13 (46.4) 16 (26.2) Severely obese, n (%) 0 4 (6.6) Normal CIMT males < 0.07 cm; abnormal CIMT males ≥ 0.07 cm; normal CIMT females < 0.065 cm; abnormal CIMT females ≥ 0.065 cm. CIMT, carotid intima–media thickness; SD, standard deviation. *Statistically significant p-value < 0.05 Table 2. Pre-operative clinical data of normal and abnormal CIMT groups Group 1 Group 2 normal CIMT abnormal CIMT Variables (n = 28, 31%) (n = 61, 69%) p-value CIMT (mm), mean ± SD 0.06 ± 0.01 0.095 ± 0.03 < 0.0001* Hypertension, n (%) 16 (57.14) 52 (85.25) 0.009* Diabetes, n (%) 2 (7.14) 21 (34.43) 0.008* Cholesterol (LDL) > 3 mmol, No analysis, n (%) 24 (85.71) 28 (45.90) incomplete mean ± SD 4.4 ± 0.07) 4.09 ± 0.94 data sets Statin use, n (%) 22 (78.57) 44 (67.21) – Hypercholesterolaemia, n (%) 14 (50.0) 24 (39.34) 0.57 NT-proBNP (ng/l), mean ± SD 562.9 ± 591.2 1344.4 ± 1646.7 0.017* Current/ex-smoker, n (%) 12 (42.86) 31 (50.82) 0.64 CK-MB isoform (ng/ml), mean ± SD 32.8 ± 96.39 20.8 ± 49.28 0.58 Glucose (mmol/l), mean ± SD 6.05 ± 2.053 6.37 ± 2.70 0.58 Insulin (mU/l), mean ± SD 24.8 ± 39.49 28.06 ± 30.71 0.74 LVEF, mean ± SD 54.4 ± 14.39 52.2 ± 15.07 0.52 EuroSCORE II, n (%) 6 (21.4) 16 (26.2) – 0–2, low risk, n (%) 11 (39.3) 20 (32.8) – 3–5, medium risk, n (%) 7 (25.0) 20 (32.8) – > 5, high risk, mean ± SD 6.18 ± 9.60 7.53 ± 13.85 0.61 Normal CIMT males < 0.70 mm; abnormal CIMT males ≥ 0.07 cm; normal CIMT females < 0.065 cm; abnormal CIMT females ≥ 0.065 cm. CIMT, carotid intima–media thickness; SD, standard deviation; LVEF, left ventricular ejection fraction. *Statistically significant p-value < 0.05. Table 3. Intra-operative clinical data of normal and abnormal CIMT groups Group 1 Group 2 normal CIMT abnormal CIMT Variables (n = 28, 31%) (n = 61, 69%) p-value Peak lactate (mmol/dl), mean ± SD 4.7 ± 1.6 4.02 ± 1.8 0.085 Cumulative bypass time (min), mean ± SD 112 ± 22.7 111.4 ± 31.5 0.92 Cumulative cross-clamp time (min), mean ± SD 60.5 ± 14.3 59.3 ± 18.5 0.75 Total number of grafts ≥ 3, n (%) 21 (75.00) 43 (70.5) 0.85 Intra-aortic balloon pump, n (%) 15 (53.6) 21 (34.4) 0.14 NIRS > 50%; drop of < 20%, n (%) 3 (10.7) 17 (27.9) 0.13 NIRS < 50%; drop of > 20%, n (%) 13 (46.5) 24 (39.3) Phenylephrine bolus at 100 μg/ml during bypass, n (%) 23 (82.1) 49 (80.3) > 0.99 mean ± SD 15.07 ± 22.04 20.7 ± 17.8 0.30 Adrenaline during anaesthesia at more than 20 μg/kg/min, n (%) 6 (21.4) 9 (14.8) 0.63 mean ± SD 0.07 ± 0.04 0.3 ± 0.4 0.16 Adrenaline bolus during bypass 1:1 000 000 mg/ml, n (%) 4 (14.3) 17 (27.9) 0.20 mean ± SD 3 ± 1.8 7 ± 9.4 0.13 Effortil bolus during bypass (mg), n (%) 2 (7.1) 5 (8.2) > 0.99 mean ± SD 14.5 ± 7.8 11.6 ± 5.4 0.69 Normal CIMT males < 0.07 cm; abnormal CIMT males ≥ 0.07cm; normal CIMT females < 0.065 cm; abnormal CIMT females ≥ 0.065 cm. CIMT, carotid intima–media thickness; SD, standard deviation. *Statistically significant p-value < 0.05.

RkJQdWJsaXNoZXIy NDIzNzc=