Diabetes is not a risk factor for hospital mortality following contemporary coronary artery bypass grafting

• Published in: Interactive cardiovascular and thoracic surgery 2007-12, Vol.6 (6), p.753-758
• Main Authors: Filsoufi, Farzan, Rahmanian, Parwis B, Castillo, Javier G, Mechanick, Jeffrey I, Sharma, Samin K, Adams, David H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Comorbidity; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Diabetes Complications - etiology; Diabetes Complications - mortality; Diabetes Mellitus - mortality; Diabetes Mellitus - surgery; Female; Follow-Up Studies; Hospital Mortality; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Odds Ratio; Retrospective Studies; Risk Assessment; Risk Factors; Sternum - surgery; Surgical Wound Infection - etiology; Surgical Wound Infection - mortality; Time Factors; Treatment Outcome
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2007.158709

a Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, 1190 Fifth Avenue, New York, NY 10029-1028, USA b Department of Medicine, Division of Endocrinology, Diabetes and Bone Disease, Mount Sinai School of Medicine, New York, NY, USA c Department of Medicine, Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA *Corresponding author. Tel.: [phone]; fax: [phone]. E-mail address : farzan.filsoufi{at}mountsinai.org (F. Filsoufi). The outcome of coronary artery bypass grafting (CABG) in diabetic patients has traditionally been worse than in non-diabetic patients. Recent studies have suggested an improvement in outcome in diabetic patients undergoing contemporary CABG. However, the direct impact of diabetes on mortality and morbidities following CABG remains unclear. We retrospectively analyzed prospectively collected data of 2725 CABG patients from January 1998 to December 2005: one thousand and eighty-five (40%) diabetics and 1640 (60%) non-diabetics [mean age 65±11 years, 1882 (69%) male]. Subgroup analysis was performed for two study periods (1998–2002 vs. 2003–2005). The overall hospital mortality was 1.8% [ n =50; diabetics: 2.4%, non-diabetics: 1.5% ( P =0.07)]. The mortality rate among diabetics decreased from 3.1% in 1998–2002 to 1.0% in 2003–2005 ( P =0.021). Diabetes was not an independent predictor of hospital mortality but predicted the occurrence of deep sternal wound infection (OR=3.77). Diabetes significantly decreased long-term survival [1-year and 5-year survival 94.7±0.7% and 81.9±1.4% for diabetic vs. 95.4±0.5% and 85.9±1.0% for non-diabetic patients ( P =0.01)]. Excellent results following contemporary CABG can be expected in diabetics with a similar mortality compared to non-diabetics. Therefore, our data suggest that diabetes may, in fact, not be a risk factor for adverse outcome following CABG. However, long-term survival in diabetics remains significantly inferior compared to non-diabetics. Key Words: Coronary artery bypass grafting; Diabetes mellitus; Risk factors; Outcome