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Original Articles: Adult Cardiac

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

^a Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
^b Dongguk University Hospital, Goyang, Korea

Accepted for publication May 10, 2010.

^_* Address correspondence to Dr Kim, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea (Email: kimkb{at}snu.ac.kr).

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. Long-term 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.

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