冠状动脉搭桥术后糖尿病患者的种族与生存情况
Race and survival among diabetic patients after coronary artery bypass grafting.
作者信息
O'Neal Wesley T, Efird Jimmy T, Davies Stephen W, O'Neal Jason B, Anderson Curtis A, Chitwood W Randolph, Ferguson T Bruce, Kypson Alan P
机构信息
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
出版信息
Thorac Cardiovasc Surg. 2014 Jun;62(4):308-16. doi: 10.1055/s-0033-1357297. Epub 2013 Oct 25.
BACKGROUND
Diabetes is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined.
METHODS
A retrospective cohort study was conducted for CABG patients between 1992 and 2011. Long-term survival was compared in patients with and without diabetes and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
RESULTS
Out of the 13,053 patients undergoing CABG, 35% (black n = 1,655; white n = 2,884) had diabetes at the time of surgery. The median follow-up for study participants was 8.2 years. Long-term survival after CABG was similar between black and white diabetic patients (no diabetes, HR = 1.0; white diabetic patients, adjusted HR = 1.5, 95%CI = 1.4-1.6; black diabetic patients, adjusted HR = 1.5, 95%CI = 1.4-1.7).
CONCLUSION
A survival disadvantage after CABG was not observed among black versus white diabetic patients in our study.
背景
糖尿病是冠状动脉旁路移植术（CABG）后长期生存率降低的已知预测因素。种族对生存率的差异尚未得到研究。
方法
对1992年至2011年间接受CABG的患者进行了一项回顾性队列研究。比较了有糖尿病和无糖尿病患者的长期生存率，并按种族进行分层。使用Cox回归模型计算风险比（HR）和95%置信区间（CI）。
结果
在13053例接受CABG的患者中，35%（黑人n = 1655；白人n = 2884）在手术时有糖尿病。研究参与者的中位随访时间为8.2年。黑人糖尿病患者和白人糖尿病患者CABG后的长期生存率相似（无糖尿病，HR = 1.0；白人糖尿病患者，调整后HR = 1.5，95%CI = 1.4 - 1.6；黑人糖尿病患者，调整后HR = 1.5，95%CI = 1.4 - 1.7）。
结论
在我们的研究中，未观察到黑人与白人糖尿病患者在CABG后存在生存劣势。
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