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Early and late outcome after coronary artery bypass surgery in diabetic patients
Authors:Dr Tapio Hakala  Otto Pitkänen  Pirjo Halonen  Juha Mustonen  Anu Turpeinen  Mikko Hippelainen
Affiliation:1. Surgery and Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finlandtapio.hakala@kuh.fi;3. Surgery and Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland;4. Computing Centre, University of Kuopio, Kuopio, Finland;5. Department of Internal Medicine, North Karelia Central Hospital, Finland
Abstract:Objective. To determine the impact of diabetes on outcome after coronary artery bypass surgery. Design. We matched 866 diabetic patients with non-diabetic controls in regards to gender, age, left ventricular ejection fraction, body mass index, presence of unstable angina and history of myocardial infarction, and day of surgery. The 30-d mortality and morbidity were evaluated with univariate analysis and survival and freedom from cardiac death were assessed with the Kaplan–Meier method. Results. Follow-up time was 69±37 months. The 30-d mortality was 2.0% in the diabetic group and 1.0% in the non-diabetic group (p=0.15). Postoperative morbidity did not differ between groups. Cumulative 5- and 10-year survival rates were 89 and 71% in diabetics and 94 and 84% in non-diabetics (p=0.001). During follow-up, there was no difference between groups in regards to repeat revascularization. Conclusions. The 30-d mortality was equally low in diabetic and non-diabetic patients with severe coronary artery disease. However, long-term survival was significantly lower in the diabetic group than in the non-diabetic group.
Keywords:Coronary artery bypass grafting  coronary artery disease  diabetes mellitus
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