Related Experiment Video
Updated: Jan 29, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Impact of Periprocedural Risk Predictors on Long-Term Outcomes in Patients with Diabetes Undergoing Coronary Artery
Aleksander Dokollari1,2, Serge Sicouri1, Basel Ramlawi1
1Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, 100 East Lancaster Avenue, Suite 215, Wynnewood, PA 19096, USA.
Insights
Patients with diabetes undergoing coronary artery bypass grafting (CABG) face higher long-term mortality risks. Diabetes is an independent predictor of poor outcomes after CABG surgery.
Area of Science:
- Cardiology
- Diabetology
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for severe coronary artery disease.
- Diabetes mellitus is a significant comorbidity affecting cardiovascular health and surgical outcomes.
- Understanding the impact of diabetes on long-term results after isolated CABG is crucial for patient management.
Purpose of the Study:
- To analyze the impact of risk predictors on long-term outcomes in patients with diabetes undergoing isolated CABG.
- To compare long-term mortality and major adverse cardiovascular and cerebrovascular events (MACCE) between diabetic and non-diabetic patients after isolated CABG.
- To identify independent predictors of mortality and MACCE in this patient population.
Main Methods:
- Retrospective analysis of consecutive patients undergoing isolated CABG from May 2005 to June 2021.
- Propensity-matched analysis comparing diabetic and non-diabetic patient groups.
- Primary outcome: long-term incidence of all-cause death. Secondary outcome: MACCE.
Main Results:
- The study included 1589 matched pairs of diabetic and non-diabetic patients with a median follow-up of 5.8 years.
- Diabetic patients had a significantly higher incidence of all-cause death (13.5% vs. 10.6%, HR 1.3, p=0.013) and MACCE (HR 1.3, p=0.049).
- Diabetes mellitus was an independent predictor for all-cause mortality (HR 1.4) and MACCE (HR 1.2). Chronic obstructive pulmonary disease, peripheral vascular disease, and high creatinine levels were also predictors.
Conclusions:
- Patients with diabetes undergoing isolated CABG experience significantly worse long-term outcomes, including higher rates of death and MACCE.
- Diabetes mellitus is a significant independent predictor of poorer long-term survival after CABG.
- Risk stratification for CABG should carefully consider the presence and management of diabetes and other comorbidities.
Abstract:
Background and Objectives: In this study, we aim to analyze the impact of risk predictors on long-term outcomes in patients with diabetes undergoing isolated coronary artery bypass grafting (CABG). Materials and Methods: All consecutive patients undergoing isolated CABG between May 2005 and June 2021 were included in the study. Patients with and without diabetes were compared for baseline demographics and pre-operative characteristics. A propensity-matched analysis was used to compare the two groups. The primary outcome was long-term incidence of all-cause death. Results: Of a total of 4871 patients, propensity matching identified 1589 pairs of patients with and without diabetes that were included in the current study. Median follow-up was 5.8 years. All-cause death was recorded in 215/1589 (13.5%) vs. 169/1589 (10.6%) patients with and without diabetes, respectively (HR 1.3, p = 0.013). MACCE was also significantly higher in diabetic patients (HR 1.3, p = 0.049). Diabetes mellitus was identified as one of the independent predictors for all-cause mortality (HR 1.4, CI 1.2, 1.7) and MACCE (HR 1.2, CI 1.0, 1.3). Chronic obstructive pulmonary disease, peripheral vascular disease, and serum creatinine levels >2.0 mg/dL were found to be the only predictors of all-cause mortality in both diabetic and non-diabetic patient groups, when individually analyzed. Conclusions: Patients with diabetes undergoing isolated CABG had a significantly higher incidence of late all-cause death and MACCE compared to those without diabetes. The presence of diabetes mellitus predicts poorer long-term outcomes following CABG.
More Related Videos
09:12Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
12:00Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
02:24Predicting Reaction Outcomes