Diabetes and survival after coronary artery bypass grafting: comparison with an age- and sex-matched population

Objective: Long-term outcome after coronary artery bypass grafting is worse in diabetic than in non-diabetic patients. No data are currently available regarding survival rates of diabetic and non-diabetic patients after coronary revascularisation compared with cohorts from the general population in the Netherlands, which were matched for age and sex (normal Dutch survival). Methods: We retrospectively analysed the data from 10 626 patients who underwent coronary artery bypass grafting between January 1998 and December 2007. Of these, 8287 patients were nondiabetic, 1587 were non-insulin-dependent and 630 were insulin-dependent diabetic patients (122 patients were lost to follow-up). Survival of these patient groups was compared with the normal Dutch survival. Results: Multivariate analyses revealed non-insulin-dependent diabetes to be a risk factor for early mortality and both insulin-dependent and non-insulin-dependent diabetes as risk factors for late mortality. The 1-, 5- and 10-year survival rates for non-diabetic patients were 94.1% +/- 0.3%, 86.8% +/- 0.4% and 75.1% +/- 1.7%, respectively, which was better than the normal Dutch survival. For insulin-dependent diabetic patients, 1-, 5- and 10-year survival rates were 90.3% +/- 1.2%, 78.0% +/- 2.0% and 60.5% +/- 4.6%, respectively, and for non-insulin-dependent diabetic patients 91.4% +/- 0.7%, 79.0% +/- 1.3% and 58.9% +/- 3.4%, respectively, which was worse than the normal Dutch survival. Conclusions: Non-insulin-dependent diabetes was a risk factor for early mortality and both types of diabetes were risk factors for late mortality after revascularisation. Compared with age- and sex-matched cohorts from the general Dutch population, the 10-year survival of non-diabetic patients was better; whereas the survival of both types of diabetic patients was worse. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.