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 10626 patients who underwent coronary artery bypass grafting between January 1998 and December 2007. Of these, 8287 patients were non-diabetic, 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.