ANALYSIS OF CLINICAL PROFILE AND OUTCOMES IN PATIENTS WITH METABOLIC RISK FACTORS AFTER CORONARY ARTERY BYPASS GRAFTING

Djuliana Mihajlovska; Milka Klinceva; Slavica Shubeska Stratrova; Sasha Mishevska Jovanovska; Marijan Boshevski; Zan Mitrev

Djuliana Mihajlovska Zan Mitrev Clinic, Skopje
Milka Klinceva Zan Mitrev Clinic, Skopje, North Macedonia
Slavica Shubeska Stratrova University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Sasha Mishevska Jovanovska University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Marijan Boshevski University Clinic of Cardiology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje,North Macedonia
Zan Mitrev Zan Mitrev Clinic, Skopje, North Macedonia

Abstract

Coronary artery bypass grafting (CABG) is a critical intervention for patients with advanced coronary artery disease, yet its success is often challenged by the presence of systemic metabolic risk factors. Factors such as hypertension, dyslipidemia, and impaired glucose metabolism create a chronic pro-inflammatory environment that can complicate surgical recovery. This study aims to evaluate how these metabolic disturbances influence early and late postoperative outcomes in a clinical setting. Material and Methods: A retrospective observational study was conducted on 19 patients with established metabolic risk factors who underwent CABG at the "Zhan Mitrev Clinic" (Skopje) between February and March 2025. Preoperative comorbidities and laboratory findings were analyzed in relation to postoperative complications. Metabolic risk was assessed using NCEP ATP III guidelines. Results: The majority of patients were male (68%), with a predominant age range of 61 to 70 years. All patients presented with hypertension and hyperlipidemia, while 36% were diagnosed with type 2 diabetes. The most frequent early postoperative complication was atrial fibrillation (42%), followed by cerebrovascular insult (16%). Long-term follow-up revealed a 5% incidence of prolonged sternal wound healing and a 5% rate of rehospitalization due to hypotension. No perioperative mortality was recorded. Conclusion: The presence of metabolic risk factors identifies a high-risk patient cohort prone to postoperative arrhythmias and delayed wound healing. Preoperative identification and aggressive optimization of these risk factors are essential to mitigate the systemic inflammatory response and improve overall surgical prognosis.

Keywords: CABG, Metabolic risk factors, Atrial fibrillation, Postoperative recovery, Inflammation.

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