PREDICTORS OF HOSPITAL COMPLICATIONS AND PROLONGED HOSPITALIZATION IN BYPASS PATIENTS: THE ROLE OF FREE FATTY ACIDS AND INSULIN RESISTANCE INDICES

Introduction. Often, carbohydrate metabolism disorders (type 2 diabetes mellitus, prediabetes) are detected in patients with severe coronary heart disease who are preparing for elective coronary bypass surgery. Insulin resistance can occur even in the absence of manifest disorders of carbohydrate metabolism and have its own influence on the course of coronary artery disease. With regard to the prognosis of coronary artery bypass grafting, the role of insulin resistance is not clearly defined, there are isolated reports on the relationship between the estimated indices of insulin resistance and free fatty acids and the number of postoperative complications of CABG Purpose of the study. To study the effect of carbohydrate metabolism disorders and insulin resistance indicators on the immediate results of coronary bypass grafting (CABG). Materials and methods. 383 consecutive patients who underwent CABG in 2011-2012 at the Research Institute of the KPSSZ were included, free fatty acids and fasting insulin in plasma were determined in all patients, insulin resistance indices HOMA-IR (Homeostasis Model Assessment of Insulin Resistance), QUICKI (Quantitative Insulin Sensitivity Chek) were calculated Index) and Revised-QUICKI, McAuley. A logistic regression analysis was performed to identify predictors of the composite endpoint of hospital stay after CABG >10 days or significant complication. Perioperative characteristics were analyzed in two cohort groups: group 1 - patients with a combined endpoint (CCT>10 days), n=291, and group 2 (n=92) without CCT. Results. In the CCT group, the median age was higher, and the proportion of women was 30% versus 14.1% (p=0.003). Patients of the 1st group (with CCT) had a higher percentage of type 2 diabetes mellitus (37.5% versus 17.4%, p