Achieving high-capacity aqueous supercapacitors via anion-doped construction of dual redox centers in NixCo1-xSeO3.

In asymmetric supercapacitors, transition metal selenates are promising electrodes, but their capacity are limited by a single redox center. To further enhance the performance of transition metal selenates, NixCo1-xSeO3 (NCSeO) doped with N and Cl was prepared on nickel-plated carbon cloth (NCSeO-NCl-NiCC). During electrochemical reactions, NCSeO can be converted to M(OH)2 (M = Ni/Co) and OH- is replaced by N and Cl. Two redox centers, M(OH)2/MOOH and M(OH)xN2-x/NO3-, are formed during charging and discharging, which is attributed to the increased capacity of the NCSeO-NCl-NiCC electrode. On NCSeO, the substitution of Cl facilitates the regulation of the electronic structure and enhances the stability of N-doping. The optimised electrode exhibits a high capacity of 417 mA h g-1 at 1 A g-1 and an impressive rate capability of 235 mA h g-1 at 50 A g-1. Asymmetric supercapacitors with this design have an ultra-high energy density of 73.6 W h kg-1, as well as an excellent rate and cycling performance with a capacitance retention of 97.8% after 20 000 cycles at a current density of 20 A g-1.

Clinical Outcomes of Surgical Revascularization Strategies Guided by Quantitative Flow Ratio in Primary Noncoronary Cardiac Surgery.

PURPOSE: Information regarding quantitative flow ratio (QFR) usage in coronary artery bypass grafting (CABG) is lacking. We compared the incidence of postoperative long-term adverse cardiovascular and cerebrovascular events after QFR-guided or coronary angiography-guided adult cardiac surgery with concurrent bypass surgery. MATERIALS AND METHODS: This study included 432 patients who underwent cardiopulmonary bypass (CPB) at our institution with at least 1 angiographical coronary artery lesion (diameter stenosis: 30% to 90%) between January 2015 and January 2016. The QFR of each patient was calculated. Patients who only underwent intraoperative coronary revascularization following the principles of optimal revascularization strategy were assigned to group A. Patients with coronary lesions not meeting the above criteria were placed in group B. RESULTS: The average number of distal anastomoses of patients with combined CABG in group B was similar to that in Group A (1.9±1.0 vs. 1.7±0.9; P=0.081). Group A had a shorter CPB duration (114.4±49.2 vs 135.8±55.2 minutes; P<0.001) and shorter aortic cross-clamping time (83.6±36.2 vs 101.1±40.6 minutes; P<0.001). The rates of perioperative mortality and major complications did not differ between groups. Long-term major adverse cardiovascular and cerebrovascular events (MACCEs) were less common in group A than in group B (14.7% vs 29.5%; P<0.001). CONCLUSIONS: In primary noncoronary cardiac surgery, despite the similar average numbers of distal anastomoses, the group with target vessels treated using an optimal coronary revascularization strategy presented shorter CPB time and aortic cross-clamping time than the other group. Multivariate analyses also showed a lower incidence of long-term MACCEs.

An oriented tube array porous carbon anode prepared using a self-blowing mold of salt templates for high-rate potassium storage.

Porous carbon materials with oriented porosity are very useful in ion batteries, but their high cost and complex fabrication hinder their wide application. In this paper, we used cheap and water-soluble NaHCO3 grains to prepare unique porous carbon with an orderly arranged tube array via one-step carbonization. During the preparation process, a novel self-blowing mold of salt templates was discovered for the first time, and the resulting numerous high-speed gas jets can act as gas state templates to induce the formation of the oriented porous carbon into a mesoscale tube array with rich micropores. Besides, the amount of CO functional groups has been enhanced greatly by the chemical activation of H2O and CO2 derived from the decomposition of NaHCO3, which can improve the reversible specific capacity of the electrode by forming a C-O-K compound with potassium. Thanks to the coupling effect of the hierarchical porous structure with an orderly tube array and rich CO functional groups, the obtained porous carbon materials exhibited excellent kinetics and impressive rate capability as the anode of potassium-ion batteries (PIBs) with high capacities of 209 mA h g-1 at 10 A g-1 and 156 mA h g-1 at 30 A g-1. This work not only provides a facile, green, sustainable approach to fabricating novel carbon materials, but also demonstrates the promising prospect of oriented porous carbon in exploring advanced electrode materials for PIBs.

Multifunctional Iron Selenate Sheath of Fe-Based Anode Achieving High-Rate Capacity-Durability Combination of Aqueous Hybrid Energy Storage Devices.

The introduction of battery-type cathode has been commonly considered a preferred approach to boost the energy density of aqueous hybrid energy storage devices (AHESDs) in alkalic systems, but AHESDs with both high energy density and power density are rare due to the great challenge in designing battery-type anode materials with high rate and durability comparable to capacitive-type carbon anodes. In this paper, a well-hydrated iron selenate (FeSeO) sheath is constructed around FeOOH nanorods by a facile electrochemical activation, demonstrating the unique multifunction in fasting charge diffusion, promoting the dissociation of H2 O, and inhibiting the irreversible phase transition of FeOOH to inert γ-Fe2 O3 , which endow the hydrated sheath coated Fe-based anodes with an impressive rate capability and superior durability. Thanks to the comprehensive performance of this Fe-based anode, the assembled AHESD delivered a high energy density of 117 Wh kg-1 with the extraordinary durability of almost 100% capacity retention after 40 000 cycles. Even at an ultrahigh power density of 27 000 W kg-1 , an impressive energy density of 65 Wh kg-1 can be achieved, which rivals previously reported energy-storage devices.

Engineering of Siloxanes for Stabilizing Silicon Anode Materials.

Silicon (Si) is considered the most promising anode material for the next generation of lithium-ion batteries (LIBs) because of its high theoretical specific capacity and abundant reserves. However, the volume expansion of silicon in the cycling process causes the destruction of the electrode structure and irreversible capacity loss. As a result, the commercial application of silicon materials is greatly hindered. In recent years, siloxane-based organosilicon materials have been widely used in silicon anode of LIBs because of their unique structure and physical and chemical properties, and have shown excellent electrochemical properties. The comprehensive achievement of siloxanes in silicon-based LIBs can be understood better through a systematic summary, which is necessary to guide the design of electrodes and achieve better electrochemical performance. This paper systematically introduces the unique advantages of siloxane materials in electrode, surface/interface modification, binder, and electrolyte. The challenges and future directions for siloxane materials are presented to enhance their performance and expand their application in silicon-based LIBs.

Inhabiting Inactive Transition by Coupling Function of Oxygen Vacancies and Fe─C Bonds achieving Long Cycle Life of an Iron-Based Anode.

Fe-based battery-type anode materials with many faradaic reaction sites have higher capacities than carbon-based double-layer-type materials and can be used to develop aqueous supercapacitors with high energy density. However, as an insurmountable bottleneck, the severe capacity fading and poor cyclability derived from the inactive transition hinder their commercial application in asymmetric supercapacitors (ASCs). In this work, driven by the "oxygen pumping" mechanism, oxygen-vacancy-rich Fe@Fe3 O4 (v) @Fe3 C@C nanoparticles that consist of a unique "fruit with stone"-like structure are developed, and they exhibit enhanced specific capacity and fast charge/discharge capability. Experimental and theoretical results demonstrate that the capacity attenuation in conventional iron-based anodes is greatly alleviated in the the Fe@Fe3 O4 (v) @Fe3 C@C anode because the irreversible phase transition to the inactive γ-Fe2 O3 phase can be inhibited by a robust barrier formed by the coupling of oxygen vacancies and Fe─C bonds, which promotes cycle stability (93.5% capacity retention after 24 000 cycles). An ASC fabricated using this Fe-based anode is also observed to have extraordinary durability, achieving capacity retention of 96.4% after 38 000 cycles, and a high energy density of 127.6 W h kg-1 at a power density of 981 W kg-1 .

Flexible aqueous supercapacitors with excellent cycling performance and high-energy density based on mesocrystalline NiCo-LDHs.

Flexible aqueous supercapacitors are promising candidates as safe power sources for wearable electronic devices (WEDs). However, the absence of advanced electrode materials with high structural stability has become the most critical factor hindering the development, which is closely related to the poor interface combination between the active substances and flexible collectors. Herein, a unique rigid layered double hydroxide (LDH) nanorod array with the mesocrystalline feature is created using the NiO-Ni layer as the inducer by the electrodeposition strategy. Differing from the traditional NiCo-LDH nanosheets directly grown on a carbon cloth, an elaborately designed NiO-Ni buffer can simultaneously and effectively improve the bidirectional combination with active substances and collectors, also the mesocrystalline LDH showed enhanced intrinsic stability through the reinforcing effect of grain boundaries. Benefiting from these, the assembled supercapacitor exhibited pre-eminent cycle stability (increased from 64% of the initial capacity after 10 000 cycles to no significant attenuation after 50 000 cycles) and ultrahigh energy density. When it was used as a flexible device, a remarkable energy density of 70.4 W h kg-1 could be harvested and processed with high flexibility in the bending state and good temperature adaptability. This study provides an excellent design strategy for the development of next-generation flexible supercapacitors with the goal of better comprehensive performances.

Surgical treatment of cardiac lipoma: 20 years' experience in a single center.

BACKGROUND: Primary cardiac lipoma is very rare, and no consensus has been developed regarding its ideal treatment strategy. This study reviewed the surgical treatment of cardiac lipomas in 20 patients over 20 years. METHODS: Twenty patients with cardiac lipomas were treated at Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2002, to January 1, 2022. The patients' clinical data and pathological reports were retrospectively analyzed, and the follow-up with a range of 1 year to 20 years was conducted. RESULTS: The cardiac lipomas were located in the right atrium (RA) or superior vena cava (SVC) in seven patients (35%) (RA in six patients and SVC in one patient), left ventricle in eight patients (40%) (left ventricular chamber in four patients and left ventricular subepicardium and myocardium in four patients), right ventricle in three patients (15%) (right ventricular chamber in one patient and right ventricular subepicardial layer and myocardium in two patients), subepicardial interventricular groove in one patient (5%), and pericardium in one patient (5%). Complete resection was achieved in 14 patients (70%), including seven patients with lipomas in the RA or SVC. Incomplete resection occurred in six patients (30%) with lipomas in the ventricles. No perioperative deaths occurred. Long-term follow-up was conducted for 19 patients (95%), including two (10%) who died. Both patients who died had lipomas incompletely resected due to ventricles involvement, and preoperative malignant arrhythmias persisted post-operatively. CONCLUSIONS: The complete resection rate was high, and the long-term prognosis was satisfactory in patients with cardiac lipomas that did not involve the ventricle. The complete resection rate was low in patients with cardiac lipomas in ventricles; and complications, including malignant arrhythmia, were common. Failure of complete resection and post-operative ventricular arrhythmia are correlated with post-operative mortality.

Molten Salt-Assisted Construction of Hollow Carbon Spheres with Outer-Order and Inner-Disorder Heterostructure for Ultra-Stable Potassium Ion Storage.

The central goal of high-performance potassium ion storage is to control the function of the anode material via rational structural design. Herein, N- and S-doped hollow carbon spheres with outer-short-range-order and inner-disorder structures are constructed to achieve highly efficient and ultra-stable potassium ion storage using a low-temperature molten salt system. The ultrathin carbon walls and uniform mesoporous as well as unique heterostructure synergistically realize significant potassium storage performance via facilitating rapid diffusion of potassium ions and alleviating substantial volume expansion. Furthermore, as the anode of a potassium ion battery, the as-prepared MSTC electrode demonstrates a state-of-the-art cycling capability of 221.3 mAh g-1 at 1 A g-1 after 20,000 cycles. The assembled potassium ion hybrid capacitor device demonstrates a high energy of 157 Wh kg-1 at 956 W kg-1 and excellent reversibility at a current density of 5.0 A g-1 after 20,000 cycles with 82.7% capacity retention. Accordingly, our work provides new ideas for designing advanced carbon anode materials and understanding the charge storage mechanism in potassium ion battery, as well as constructing high energy-power density potassium-ion hybrid capacitors (PIHCs).

Achieving Ultrahigh Energy-Density Aqueous Supercapacitors via a Novel Acidic Radical Adsorption Capacity-Activation Mechanism in Ni(SeO3 )/Metal Sulfide Heterostructure.

Transitional metal chalcogenide (TMC) is considered as one promising high-capacity electrode material for asymmetric supercapacitors. More evidence indicates that TMCs have the same charge storage mechanism as hydroxides, but the reason why TMC electrode materials always provide higher capacity is rare to insight. In this work, a Nix Coy Mnz S/Ni(SeO3 ) (NCMS/NSeO) heterostructure is prepared on Ni-plated carbon cloth, validating that both NCMS and NSeO can be transformed into hydroxides in electrochemical process as accompanying with the formation of SeO3 2- and SOx 2- in confined spaces of NCMS/NSeO/Ni sandwich structure. Based on density functional theory calculation and experimental results, a novel space-confined acidic radical adsorption capacity-activation mechanism is proposed for the first time, which can nicely explain the capacity enhancement of NCMS/NSeO electrode materials. Thanks to the unique capacity enhancement mechanism and stable NCMS/NSeO/Ni sandwich structure, the optimized electrodes exhibit a high capacity of 536 mAh g-1 at 1 A g-1 and the impressive rate capability of 140.5 mAh g-1 at the amazing current density of 200 A g-1 . The assembled asymmetric supercapacitor achieves an ultrahigh energy density of 141 Wh Kg-1 and an impressive high-rate capability and cyclability combination with 124% capacitance retention after 10 000 cycles at a large current density of 50 A g-1 .

Fractal Geometry Illustrated Left Atrial Appendage Morphology That Predicted Thrombosis and Stroke in Patients With Atrial Fibrillation.

Background: This study aims to correlate the morphological complexity of left atrial appendage (LAA) with thrombosis and stroke in patients with atrial fibrillation (AF). Methods: The training cohort consisted of 46 patients with AF (age 55.8 ± 7.2 years, 73.9% men) who were referred for radiofrequency catheter ablation. An independent validation cohort consisting of 443 patients with AF was enrolled for further verification. All patients in the training cohort underwent both transesophageal echocardiography (TEE) and enhanced computed tomography (CT). Fractal dimension (FD) analysis was performed to evaluate the morphological complexity of LAAs quantitatively. Clinical and imaging manifestations, FD of LAAs, and diagnostic accuracy were investigated and compared between patients with AF in both training and validation cohorts. Results: In the training cohort, LAAs (n = 22) with thrombi had significantly higher FD than those without thrombi (n = 24) h 0.44 ± 0.07 vs. 2.35 ± 0.11, p = 0.003). Receiver-operating characteristic (ROC) analysis suggested that the diagnostic accuracy of FD combined with a CHA2DS2-VaSc score was significantly higher than that of the CHA2DS2-VaSc score alone in low- to moderate-risk patients with AF (area under the curve 0.8479 vs. 0.6958, p = 0.009). The results were also validated in an independent external validation cohort and demonstrated that increased FD was associated with stroke. Hemodynamic analysis revealed that LAAs with thrombi and high FD were prone to blood stasis and lower blood flow rate. Conclusion: LAA morphological complexity is closely associated with thrombosis and stroke in patients with paroxysmal AF. A new risk assessment system combining CHA2DS2-VaSc score and FD has a higher diagnostic accuracy in predicting LAA thrombosis.

N-doped engineering of a high-voltage LiNi0.5Mn1.5O4 cathode with superior cycling capability for wide temperature lithium-ion batteries.

Spinel LiNi0.5Mn1.5O4 (LNMO) is one potential cathode candidate for next-generation high energy-density lithium-ion batteries (LIBs). However, serious capacity decay from its poor structural stability, especially at high operating temperatures, shadows its application prospects. In this work, N-doped LNMO (LNMON) was synthesized by a facile co-precipitation method and multistep calcination, exhibiting a unique yolk-shell architecture. Concurrently, N dopants are introduced into a LNMO lattice, endowing LNMON with a more stable structure via stronger Ni-N/Mn-N bindings. Benefiting from the synergistic effect of the yolk-shell structure and N-doped engineering, the obtained LNMON cathode exhibits an impressive rate and the state-of-the-art cycling capability, delivering a high capacity of 103 mA h g-1 at 25 °C after 8000 cycles. Even at a high operating temperature of 60 °C, the capacity retention remains at 92% after 1000 cycles. The discovery of N dopants in improving the cycling capability of LNMO in our case offers a prospective approach to enable 5 V LNMO cathode materials with excellent cycling capability.

Biomineralized Mesocrystal KCl Microreactor for Solid-State Synthesis of Non-Oxide Nanomaterials.

Inspired by natural biomineralization, a biomineralized microreactor with a mesocrystal KCl shell (BM-KCl-MMs) is made by a facile freezing dry process, exhibiting a good availability for high-temperature solid-state synthesis of nanomaterials. Benefiting from the good thermal stability, stiffness, and mechanical strength of KCl mesocrystal shells, the employment of BM-KCl-MMs in the transition metal (TM)-S-Se system not only realizes for the first time, the production of TMSx Se2- x /C nanocomposites in air atmosphere, but also reaches a high reagent-utilization and high yield, as well as minimum wastes. More importantly, based on the soaking effect of the KCl shells, the resultant stable reaction microenvironment inside endows the microreactors with a well-controlled synthesis of nanomaterials with very even size, uniform dispersion, and novel functionalities. As one example, the as-prepared MoSx Se2- x /C composites as the electrodes of K-ion batteries and K-ion hybrid supercapacitors deliver the state of the art cycling capability of 248 mAh g-1 at 2 A g-1 after 5000 cycles and an 87.1% capacity retention at 5.0 A g-1 after 20 000 cycles, respectively, demonstrating a significant potential of BM-KCl-MMs on design and synthesis of novel functional nanomaterials.

Surgical radiofrequency ablation of atrial flutter: which operation should we choose?

The treatment of atrial flutter (AFL) in patients without structural heart disease (SHD) by transcatheter radiofrequency ablation of the cavotricuspid isthmus (CTI) and bilateral pulmonary veins has achieved good results. We report three cases of typical AFL treated by surgical radiofrequency ablation. One patient, without SHD, successfully underwent CTI ablation and cardioversion. The other two patients, with SHD, underwent CTI ablation, partial right atrial ablation and pulmonary vein isolation, but a normal sinus rhythm was not achieved. Therefore, standard maze IV surgery may be the best choice in patients with AFL and SHD.

Fe nanopowder-assisted fabrication of FeOx/porous carbon for boosting potassium-ion storage performance.

The electrode materials of potassium ion storage system have attracted considerable attention given the promising prospect of a potassium ion system in large-scale electrochemical energy storage applications. Despite the excellent anode performance of metal oxides in Li+ and Na+ batteries, the study on their K+ storage performance is still rarely reported. In this study, we report a safe and low-cost strategy to prepare FeOx/N-doped carbons by using NaHCO3 and Fe nanopowder. Benefiting from the oxidation of Fe to Fe3O4, an interesting "one stone, two birds" role of the Fe powder can be identified in the heating process. As a reduction agent, the Fe powder can consume the excess oxygen in the bio-massed carbon framework, facilitating the formation of short-range-ordered domains in the biomass-derived carbon materials (FeOx@GBHCs). Moreover, the close combination of oxidization products (Fe3O4 particles) and carbon matrix leads to numerous FeOx clusters grafted on the surface of the carbon framework via the strong C-O-Fe binding. Therefore, the resultant FeOx/porous carbon exhibits a high reversible capacity of 410 mA h g-1 and an excellent cycling capability. The assembled FeOx@GBHCs//AC potassium-ion hybrid supercapacitor delivers a high energy density of 133 W h kg-1 at a power density of 700 W kg-1, demonstrating a potential prospect of metal oxides in boosting the potassium ion storage performance.

Educational Attainment and Ischemic Stroke: A Mendelian Randomization Study.

Observational studies have evaluated the potential association of socioeconomic factors such as higher education with the risk of stroke but reported controversial findings. The objective of our study was to evaluate the potential causal association between higher education and the risk of stroke. Here, we performed a Mendelian randomization analysis to evaluate the potential association of educational attainment with ischemic stroke (IS) using large-scale GWAS datasets from the Social Science Genetic Association Consortium (SSGAC, 293,723 individuals), UK Biobank (111,349 individuals), and METASTROKE consortium (74,393 individuals). We selected three Mendelian randomization methods including inverse-variance-weighted meta-analysis (IVW), weighted median regression, and MR-Egger regression. IVW showed that each additional 3.6-year increase in years of schooling was significantly associated with a reduced IS risk (OR = 0.54, 95% CI: 0.41-0.71, and p = 1.16 × 10-5). Importantly, the estimates from weighted median (OR = 0.49, 95% CI: 0.33-0.73, and p = 1.00 × 10-3) and MR-Egger estimate (OR = 0.18, 95% CI: 0.06-0.60, and p = 5.00 × 10-3) were consistent with the IVW estimate in terms of direction and magnitude. In summary, we provide genetic evidence that high education could reduce IS risk.

Mn and Co co-doped perovskite fluorides KNiF3 with enhanced capacitive performance.

Perovskite-based aqueous supercapacitors have important development prospects due to their advantages of high energy density, low cost, environmental benignity. Here, bimetallic Ni-Mn and trimetallic Ni-Co-Mn perovskite fluorides are prepared via facile solvothermal method and characterized as positive electrode materials for supercapacitors. The structure, composition, chemical states and the electrochemical properties of these samples are investigated in detail. Three electrode measurements indicate that the electrochemical properties of the perovskite fluorides KNiF3 depend on the nature and amount of dopants. Partial doping of Ni by Mn increases the rate capability but decreases the specific capacity, while Co and Mn co-doping improve both the rate capability and specific capacity of perovskite fluoride KNiF3. The K-Ni-Co-Mn-F (Ni/Co/Mn = 12:2:1) sample exhibits the maximum specific capacity of 211 mAh g-1, low internal resistance and a high rate capability (82% capacity retention from 1 to 16 A g-1). Furthermore, the AC//K-Ni-Co-Mn-F (Ni/Co/Mn = 12:2:1) asymmetric supercapacitor delivers a maximum energy density of 50.2 Wh kg-1. These results prove that Co and Mn co-doped KNiF3 can be a promising material for supercapacitor.

Protective effects of omega-3 fatty acids against Alzheimer's disease in rat brain endothelial cells.

OBJECTIVES: Omega-3 fatty acids are well-known unsaturated fatty acids that are essential for growth and development in animals. They primarily participate in the development of intelligence, the nervous system, and vision, and the metabolism of neurotransmitters. Omega-3 fatty acids have been widely studied in the treatment of Alzheimer's disease (AD). Omega-3 fatty acids are known to have neuroprotective effects due to their antioxidant capacity. Rotenone has been shown to induce neurotoxicity in vitro. METHODS: We investigated the protective effects of omega-3 fatty acids against AD in rat brain microvascular endothelial cells (RBMVECs) in vitro. Lipid peroxidation, reactive oxygen species (ROS), glutathione peroxidase (Gpx), reduced glutathione (GSH), superoxide dismutase (SOD), and catalase levels were evaluated in RBMVECs. Flow cytometry was performed to assess apoptosis. RESULTS: Lipid peroxidation and ROS were reduced in RBMVECs following incubation with omega-3 fatty acids. Catalase, Gpx, and SOD were increased in RBMVECs following incubation with omega-3 fatty acids. Flow cytometry showed that incubation with omega-3 fatty acids reduced the amount of apoptotic RBMVECs. CONCLUSION: Our results suggest that omega-3 fatty acids show potential as a therapeutic agent against AD.

Routine use of bilateral internal mammary artery grafts for myocardial revascularization in diabetic patients: a propensity score matched study / 中国胸心血管外科临床杂志

@#Objective To evaluate the influence of diabetes on coronary artery bypass graft (CABG) surgery using bilateral internal mammary artery (BIMA). Methods From December 2015 to August 2017, 182 patients (153 males, 29 females, age of 56.5±6.8 years) underwent CABG using BIMA. The propensity score was used to create matched diabetes (n=66) and non-diabetes (n=66) cohorts. The operative data, post-operative outcomes and coronary computed tomographic angiography (CTA) of the diabetes group (53 males, 13 females, age of 57.8±7.2 years) and the non-diabetes group (56 males, 10 females, age of 56.3±6.0 years) were analyzed retrospectively. Results There was no peri-operative mortality. There was no difference in operative sternal wound complication (P=0.466), or graft patency (P=0.730 for internal mammary arteries and 0.684 for saphenous vein grafts) between the matched diabetes and the non-diabetes groups. However, patients with elevated glycated hemoglobin (HbA1c) (n=54) had more sternal wound complications (P=0.006). The level of Hb1Ac of the patients with sternal wound complication was significantly higher than that of the patients without sternal wound complication. Conclusion BIMA grafting may be performed routinely even in diabetic patients, without increased complications. However, elevated HbA1c level should be avoided to reduce sternal wound complication.