Long-Term Nitrogen Dioxide Exposure as a Possible 5-Year Mortality Risk Factor in Diabetic Patients Treated Using Off-Pump Surgical Revascularization—A Retrospective Analysis
Tomasz Urbanowicz,
Krzysztof Skotak,
Aleksandra Krasińska-Płachta,
Mariusz Kowalewski,
Anna Olasińska-Wiśniewska,
Krystian Szczepański,
Andrzej Tykarski,
Beata Krasińska,
Zbigniew Krasiński,
Marek Jemielity
Affiliations
Tomasz Urbanowicz
Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland
Krzysztof Skotak
Institute of Environmental Protection—National Research Institute, 02-170 Warsaw, Poland
Aleksandra Krasińska-Płachta
Department of Ophthalmology, Poznan University of Medical Sciences, 60-569 Poznan, Poland
Mariusz Kowalewski
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland
Anna Olasińska-Wiśniewska
Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland
Krystian Szczepański
Institute of Environmental Protection—National Research Institute, 02-170 Warsaw, Poland
Andrzej Tykarski
Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland
Beata Krasińska
Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland
Zbigniew Krasiński
Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Science, 61-848 Poznan, Poland
Marek Jemielity
Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland
Background: There is mounting evidence that diabetic-related cardiac metabolism abnormalities with oxidative stress and inflammatory mechanism activation align with the functional impairments that result in atherosclerotic lesion formation. Among the possible non-traditional coronary lesion risk factors, environmental exposure may be significant, especially in diabetic patients. Methods: A total of 140 diabetic patients (115 (82%) males and 25 (18%) females) with a mean age of 65 (60–71) underwent surgical revascularization due to multivessel coronary disease. The possible all-cause mortality risk factors, including demographical and clinical factors followed by chronic air pollution exposure, were identified. Results: All patients were operated on using the off-pump technique and followed for 5.6 (5–6.1) years. The multivariable model for 5-year mortality prediction presented the nitrogen dioxide chronic exposure (HR: 3.99, 95% CI: 1.16–13.71, p = 0.028) and completeness of revascularization (HR: 0.19, 95% CI: 0.04–0.86, p = 0.031) as significant all-cause mortality risk factors. Conclusions: Ambient air pollutants such as an excessive chronic nitrogen dioxide concentration (>15 µg/m3) may increase 5-year all-cause mortality in diabetic patients following surgical revascularization.
