Diabetes Care, Vol 19, Issue 7 698-703, Copyright © 1996 by American Diabetes Association

ARTICLES

Mortality and morbidity in diabetic and nondiabetic patients during a 2-year period after coronary artery bypass grafting

J Herlitz, GB Wognsen, H Emanuelsson, M Haglid, BW Karlson, T Karlsson, P Albertsson and S Westberg
Division of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden.

OBJECTIVE: To describe mortality and morbidity during a 2-year period after coronary artery bypass grafting (CABG) among diabetic and nondiabetic patients. RESEARCH DESIGN AND METHODS: All the patients in western Sweden in whom CABG was undertaken between June 1988 and June 1991 and in whom concomitant procedures were not performed were registered prospectively. The study was a prospective follow-up. RESULTS: Diabetic patients (n = 268) differed from nondiabetic patients (n = 1,859) in that more women were included, and the patients more frequently had a previous history of myocardial infarction (MI), hypertension, congestive heart failure, intermittent claudication, and obesity. Diabetic patients more frequently required reoperation and had a higher incidence of peri- and postoperative neurological complications. Mortality during the 30 days after CABG was 6.7% in diabetic patients versus 3.0% in nondiabetic patients (P < 0.01). Mortality between day 30 and 2 years was 7.8 and 3.6%, respectively (P < 0.01). During 2 years of follow-up, a history of diabetes appeared to be a significant independent predictor of death. Whereas the development of MI after discharge from the hospital did not significantly differ between the two groups; 6.3% of diabetic patients developed stroke versus 2.5% in nondiabetic patients (P < 0.001). CONCLUSIONS: Diabetic patients have a mortality rate during the 2-year period after CABG that is about twice that of nondiabetic patients during both the early and late phase after the operation.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. Marcheix, F. Vanden Eynden, P. Demers, D. Bouchard, and R. Cartier Influence of diabetes mellitus on long-term survival in systematic off-pump coronary artery bypass surgery. Ann. Thorac. Surg., October 1, 2008; 86(4): 1181 - 1188. [Abstract] [Full Text] [PDF]

				S. Mohammadi, F. Dagenais, P. Mathieu, J. G. Kingma, D. Doyle, S. Lopez, R. Baillot, J. Perron, E. Charbonneau, E. Dumont, et al. Long-Term Impact of Diabetes and Its Comorbidities in Patients Undergoing Isolated Primary Coronary Artery Bypass Graft Surgery Circulation, September 11, 2007; 116(11_suppl): I-220 - I-225. [Abstract] [Full Text] [PDF]

				J. van der Linden, P. Bergman, and L. Hadjinikolaou The Topography of Aortic Atherosclerosis Enhances Its Precision as a Predictor of Stroke Ann. Thorac. Surg., June 1, 2007; 83(6): 2087 - 2092. [Abstract] [Full Text] [PDF]

				L. R. Schmeltz, A. J. DeSantis, V. Thiyagarajan, K. Schmidt, E. O'Shea-Mahler, D. Johnson, J. Henske, P. M. McCarthy, T. G. Gleason, E. C. McGee, et al. Reduction of Surgical Mortality and Morbidity in Diabetic Patients Undergoing Cardiac Surgery With a Combined Intravenous and Subcutaneous Insulin Glucose Management Strategy Diabetes Care, April 1, 2007; 30(4): 823 - 828. [Abstract] [Full Text] [PDF]

				R. E. Gilbert, K. Connelly, D. J. Kelly, C. A. Pollock, and H. Krum Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 193 - 208. [Abstract] [Full Text] [PDF]

				J.-S. Choi, K. R. Cho, and K.-B. Kim Does Diabetes Affect the Postoperative Outcomes After Total Arterial Off-Pump Coronary Bypass Surgery in Multivessel Disease? Ann. Thorac. Surg., October 1, 2005; 80(4): 1353 - 1360. [Abstract] [Full Text] [PDF]

				A. Tsang, D. J. Hausenloy, M. M. Mocanu, R. D. Carr, and D. M. Yellon Preconditioning the Diabetic Heart: The Importance of Akt Phosphorylation Diabetes, August 1, 2005; 54(8): 2360 - 2364. [Abstract] [Full Text] [PDF]

				C. Kubal, A. K. Srinivasan, A. D. Grayson, B. M. Fabri, and J. A.C. Chalmers Effect of Risk-Adjusted Diabetes on Mortality and Morbidity After Coronary Artery Bypass Surgery Ann. Thorac. Surg., May 1, 2005; 79(5): 1570 - 1576. [Abstract] [Full Text] [PDF]

				O. Jarvinen, J. Julkunen, T. Saarinen, J. Laurikka, and M. R. Tarkka Effect of Diabetes on Outcome and Changes in Quality of Life After Coronary Artery Bypass Grafting Ann. Thorac. Surg., March 1, 2005; 79(3): 819 - 824. [Abstract] [Full Text] [PDF]

				A. Norhammar, K. Malmberg, E. Diderholm, B. Lagerqvist, B. Lindahl, L. Ryden, and L. Wallentin Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization J. Am. Coll. Cardiol., February 18, 2004; 43(4): 585 - 591. [Abstract] [Full Text] [PDF]

				M. Galinanes and A. G Fowler Role of clinical pathologies in myocardial injury following ischaemia and reperfusion Cardiovasc Res, February 15, 2004; 61(3): 512 - 521. [Abstract] [Full Text] [PDF]

				N. Luciani, G. Nasso, M. Gaudino, A. Abbate, F. Glieca, F. Alessandrini, F. Girola, F. Santarelli, and G. Possati Coronary artery bypass grafting in Type II diabetic patients: a comparison between insulin-dependent and non-insulin-dependent patients at short- and mid-term follow-up Ann. Thorac. Surg., October 1, 2003; 76(4): 1149 - 1154. [Abstract] [Full Text] [PDF]

				A. Roguin, W. Koch, A. Kastrati, D. Aronson, A. Schomig, and A. P. Levy Haptoglobin Genotype Is Predictive of Major Adverse Cardiac Events in the 1-Year Period After Percutaneous Transluminal Coronary Angioplasty in Individuals With Diabetes Diabetes Care, September 1, 2003; 26(9): 2628 - 2631. [Abstract] [Full Text] [PDF]

				K.-H. Mak and D. P. Faxon Clinical studies on coronary revascularization in patients with type 2 diabetes Eur. Heart J., June 2, 2003; 24(12): 1087 - 1103. [Abstract] [Full Text] [PDF]

				A. F.L. Schinkel, J. J. Bax, R. Valkema, A. Elhendy, R. T. van Domburg, E. C. Vourvouri, M. A. Bountioukos, E. P. Krenning, J. R.T.C. Roelandt, and D. Poldermans Effect of Diabetes Mellitus on Myocardial 18F-FDG SPECT Using Acipimox for the Assessment of Myocardial Viability J. Nucl. Med., June 1, 2003; 44(6): 877 - 883. [Abstract] [Full Text] [PDF]

				F. A. McAlister, J. Man, L. Bistritz, H. Amad, and P. Tandon Diabetes and Coronary Artery Bypass Surgery: An examination of perioperative glycemic control and outcomes Diabetes Care, May 1, 2003; 26(5): 1518 - 1524. [Abstract] [Full Text] [PDF]

				A. M. Lincoff Important Triad in Cardiovascular Medicine: Diabetes, Coronary Intervention, and Platelet Glycoprotein IIb/IIIa Receptor Blockade Circulation, March 25, 2003; 107(11): 1556 - 1559. [Full Text] [PDF]

				A. M. Calafiore, M. Di Mauro, G. Di Giammarco, M. Contini, G. Vitolla, A. Lorena Iaco, C. Canosa, and S. D'Alessandro Effect of diabetes on early and late survival after isolated first coronary bypass surgery in multivessel disease J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 144 - 154. [Abstract] [Full Text] [PDF]

				M. Laakso and J. Kuusisto Diabetology for cardiologists Eur. Heart J. Suppl., January 1, 2003; 5(suppl_B): B5 - B13. [Abstract] [PDF]

				Z. Szabo, E. Hakanson, and R. Svedjeholm Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting Ann. Thorac. Surg., September 1, 2002; 74(3): 712 - 719. [Abstract] [Full Text] [PDF]

				J. L. Carson, P. M. Scholz, A. Y. Chen, E. D. Peterson, J. Gold, and S. H. Schneider Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery J. Am. Coll. Cardiol., August 7, 2002; 40(3): 418 - 423. [Abstract] [Full Text] [PDF]

				V. Mathew and D. R. Holmes Outcomes in diabetics undergoing revascularization: The long and the short of it J. Am. Coll. Cardiol., August 7, 2002; 40(3): 424 - 427. [Full Text] [PDF]

				S. Verma, A. Maitland, R. D. Weisel, P. W. M. Fedak, S.-H. Li, D. A. G. Mickle, R.-K. Li, L. Ko, and V. Rao Increased endothelin-1 production in diabetic patients after cardioplegic arrest and reperfusion impairs coronary vascular reactivity: Reversal by means of endothelin antagonism J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1114 - 1119. [Abstract] [Full Text] [PDF]

				M. Matsa, Y. Paz, J. Gurevitch, I. Shapira, A. Kramer, D. Pevny, and R. Mohr Bilateral skeletonized internal thoracic artery grafts in patients with diabetes mellitus J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 668 - 674. [Abstract] [Full Text] [PDF]

				W. Whang, J. T. Bigger Jr., and The CABG Patch Trial Investigators and Coordinator Diabetes and outcomes of coronary artery bypass graft surgery in patients with severe left ventricular dysfunction: results from The CABG Patch Trial database J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1166 - 1172. [Abstract] [Full Text] [PDF]

				T. Hammoud, J.-F. Tanguay, and M. G. Bourassa Management of coronary artery disease: therapeutic options in patients with diabetes J. Am. Coll. Cardiol., August 1, 2000; 36(2): 355 - 365. [Abstract] [Full Text] [PDF]

				K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]

				S. M. Grundy, I. J. Benjamin, G. L. Burke, A. Chait, R. H. Eckel, B. V. Howard, W. Mitch, S. C. Smith Jr, and J. R. Sowers Diabetes and Cardiovascular Disease : A Statement for Healthcare Professionals From the American Heart Association Circulation, September 7, 1999; 100(10): 1134 - 1146. [Full Text] [PDF]

				H. Belzberg and A. I. Rivkind Preoperative Cardiac Preparation Chest, May 1, 1999; 115(suppl_2): 82S - 95S. [Abstract] [Full Text] [PDF]

				M K RUTTER, S M MARSHALL, and J M McCOMB Coronary artery disease and diabetes Heart, December 1, 1997; 78(6): 527 - 529. [Full Text] [PDF]