Diabetes Does Not Affect Long-Term Results After Total Arterial Off-Pump Coronary Revascularization

作者：Hwang Ho Young; Choi Jae Sung; Kim Ki Bong^*

来源：Annals of Thoracic Surgery, 2010, 90(4): 1180-1186.

DOI：10.1016/j.athoracsur.2010.05.021

Background. We evaluated the influence of diabetes mellitus (DM) on 5-year angiographic results and long-term clinical outcomes in patients who underwent total arterial off-pump coronary revascularization for multivessel coronary disease.
Methods. Between January 1998 and July 2004, total arterial revascularization for multivessel coronary disease was performed in 558 patients; 247 patients were diabetic (DM group) and 311 were nondiabetic (NDM group). Follow-up duration was 81 +/- 26 months. Longterm survival, cardiac deaths, and major advanced cardiovascular or cerebral events were studied. Effects of DM on early, 1-year, and 5-year graft patency rates were compared using the generalized linear mixed model.
Results. No differences in operative mortality and morbidity were observed. Overall survival in the DM group was significantly lower (p = 0.004), with 10-year survival rates of 78.5% (vs 88.1% in the NDM group).Independent risk factors for long-term survival included smoking, chronic renal failure, and preoperative left ventricular dysfunction, but not DM itself. No differences in freedom from cardiac death were found between the 2 groups (p = 0.171). Freedom from reintervention and major adverse cardiovascular and cerebral events were also similar between the groups. Early, 1-year, and 5-year postoperative angiographic patency rates in the DM group were 98.2%, 95.3%, and 94.6%, respectively. Those of the NDM group were 98.6%, 94.7%, and 90.5%. Diabetes mellitus did not affect graft patency rates.
Conclusions. Diabetes mellitus did not affect 5-year angiographic results, long-term survival, and clinical events in patients with multivessel coronary disease who underwent total arterial off-pump revascularization.

• 出版日期2010-10