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. 2023 May 12;23(1):248.
doi: 10.1186/s12872-023-03279-8.

7-year outcomes in diabetic patients after coronary artery bypass graft in a developing country

Parmida Sadat Pezeshki  1 , Farzad Masoudkabir  2   3 , Mina Pashang  4 , Ali Vasheghani-Farahani  5 , Arash Jalali  4 , Saeed Sadeghian  4 , Kaveh Hosseini  4 , Soheil Mansourian  6 , Shahram Momtahan  6 , Abbasali Karimi  4
Affiliations

7-year outcomes in diabetic patients after coronary artery bypass graft in a developing country

Parmida Sadat Pezeshki et al. BMC Cardiovasc Disord. .

Abstract

Background: Revascularization in diabetic patients with coronary artery disease remains a challenge in cardiology practice. Although clinical trials have reported the mid-term superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention in these patients, little is known about the long-term outcomes of CABG in diabetic patients compared to non-diabetics, particularly in developing countries.

Methods: Between 2007 and 2016, we recruited all patients who underwent isolated CABG in a tertiary care cardiovascular center in a developing country. The patients were followed at 3-6 months and 12 months after surgery, and then annually. The study endpoints were 7-year all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).

Results: Of 23,873 patients (17,529 males, mean age 65.67 years) who underwent CABG, 9227 (38.65%) patients were diagnosed with diabetes. After adjustment for potential confounders, patients with diabetes experienced a 31% increase in MACCE seven years after surgery compared to the non-diabetic patients (HR = 1.31, 95% CI: 1.25-1.38, P-value < 0.0001). Meanwhile, diabetes contributes to a 52% increase in the risk of all-cause mortality after CABG (HR = 1.52, 95% CI: 1.42-1.61, P-value < 0.0001).

Conclusions: Our study showed a higher risk of all-cause mortality and MACCE at seven years in diabetic patients undergoing isolated CABG. The outcomes in the studied center in a developing country were comparable to western centers. The high incidence of adverse outcomes in the long term in diabetic patients implies that not only short-term but long-term measures should be taken to improve the CABG outcomes in this challenging patient population.

Keywords: Acute coronary syndrome; Coronary artery bypass graft surgery; Diabetes; Major adverse cardiac and cerebrovascular events; Revascularization.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Adjusted cumulative hazard of death and major adverse cardiac and cerebrovascular events (MACCE). Adjusted cumulative hazard of death (a) and major adverse cardiac and cerebrovascular events (MACCE) (b) after coronary artery bypass grafting (CABG) surgery according to the diabetes status is analyzed using the cox proportional hazards model and depicted
Fig. 2
Fig. 2
Adjusted cumulative hazard of death and major adverse cardiac and cerebrovascular events (MACCE). The Adjusted cumulative hazard of death (a) and major adverse cardiac and cerebrovascular events (MACCE) (b) after coronary artery bypass grafting (CABG) surgery according to the diabetes status by applying the inverse probability weighting (IPW) model is calculated and demonstrated
See this image and copyright information in PMC

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