ABSTRACT

Hong Kong Med J 2009;15:173-8 | Number 3, June 2009
ORIGINAL ARTICLE
Impact of diabetes on early and mid-term survival after coronary artery bypass graft surgery in the Hong Kong Chinese population
WK Au, KT Lam, LC Cheng, SW Chiu
Division of Cardiothoracic Surgery, Department of Surgery, The University of Hong Kong, Grantham Hospital, Hong Kong
 
 
OBJECTIVE. To determine the impact of diabetes on early and mid-term survival in the Hong Kong Chinese population undergoing coronary artery bypass graft surgery.
 
DESIGN. Prospective study.
 
SETTING. Regional hospital, Hong Kong.
 
PATIENTS. A total of 904 consecutive patients following coronary artery bypass graft surgery from November 1999 to December 2003 were prospectively analysed. Among them, 377 (42%) diabetic and 527 (58%) non-diabetic patients were evaluated.
 
MAIN OUTCOME MEASURES. Hospital mortality, mid-term mortality, and percutaneous coronary intervention-free survival.
 
RESULTS. The diabetic group had a higher risk score than the non-diabetic group (mean+/-standard deviation: EuroSCORE 4.7+/-3.4 and 3.6+/-3.4, respectively; P<0.001). Hospital mortality was 3.4% in the diabetic group compared to 2.8% in the non-diabetic group (P=0.698). Multiple logistic regression analysis identified left ventricular ejection fraction of less than 30% and preoperative intubation as independent risk factors for early hospital death. There were 81 late deaths and the actuarial survival at 48 months for the diabetic and non-diabetic patients were 86% and 90%, respectively (P=0.298). The angina-free survival and percutaneous coronary intervention-free survival at 48 months for the diabetic and non-diabetic patients yielded no statistically significant difference.
 
CONCLUSIONS. Diabetes mellitus was not a predictor of early and mid-term mortality after coronary artery bypass graft surgery in our Chinese population. Furthermore, diabetes did not affect angina recurrence or intervention free-survival up to 4 years.
 
Key words: Coronary artery bypass; Coronary disease; Diabetes mellitus; Survival analysis
 
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