Impact of Diabetic Retinopathy on Cardiac Outcome After Coronary Artery Bypass Surgery in India

Abstract

Diabetic Retinopathy (DR) is a frequent and early sign of microvascular complication of diabetes, and the risk of retinopathy is directly related to the degree and duration of hyperglycemia. Coronary artery disease is the leading cause of death in diabetics. Coronary artery bypass graft surgery (CABG) is the preferred strategy for coronary revascularization in patients with diabetes mellitus and multivessel coronary artery disease (MVD). However, even after CABG, the long-term outcome among diabetics is suboptimal as compared with among nondiabetics. This unfavorable prognosis is believed to be related to more rapid progression of atherosclerosis within native coronary arteries and grafts, a high prevalence of myocardial infarction (MI) and persistence or recurrence of congestive heart failure among diabetics who have undergone CABG. Recently, epidemiologic studies have reported that patients with severe DR have a high risk of death from coronary artery disease (CAD). Therefore diabetics with retinopathy could constitute some proportion of candidates for CABG. However, little is known about the prognostic value of DR among diabetics after CABG in Indian population. This study will attempt to assess the impact of DR on the longterm outcome of CABG among diabetics in Madurai, India. newline