Abstract
Background: Diabetes is one of the most frequent comorbidities in patients undergoing coronary artery bypass grafting (CABG). Today, half of the patients who need CABG suffer from diabetes. Those patients tend to present poor prognosis as compared with nondiabetic patients. However, the most influential factor in surgical outcomes of CABG patients with diabetes remains unclear. The purpose of this study was to identify risk factors that contribute to poor post-CABG prognosis in patients with diabetes. Methods: A total of 1,139 patients underwent CABG from January 2000 through July 2015. Of those patients, 599 patients had diabetes (DM group), and the other 540 patients did not (non-DM group). We retrospectively investigated early and late clinical outcomes between the 2 groups. In the DM group, multivariable analysis was performed to identify the risk factors for survival. Results: The diabetic patients had more incidents of comorbidities than the nondiabetic patients. However, hospital mortality after CABGs between the two groups was similar even though the incidence of deep sternal infection, renal failure, and respiratory failure were higher in the DM group than in the non-DM group. All-cause mortality during follow-up was significantly higher in the DM group. The predictors of poor prognosis for diabetic patients after CABGs were old age, peripheral vascular diseases, severity of carotid atherosclerosis, and hemodialysis, not the number of arterial grafts used. Conclusions: Poor prognosis factors after CABGs in diabetic patients were concomitant chronic renal failure and advanced atherosclerosis. The number of arterial grafts used in the CABGs had no influence on the long-term mortality of patients with diabetes.
