Effect of Diabetes Mellitus on Early and Mid-Term Results after Off-Pump CABG

(Department of Cardiovascular Surgery, Kanto Medical Center NTT EC, Tokyo, Japan)

Yoshitsugu Nakamura Kiyoharu Nakano Hayao Nakatani
Akihiko Gomi Atsuhiko Sato Koichi Sugimoto
It has been reported that diabetes mellitus is a significant risk factor for adverse outcomes after conventional CABG using cardiopulmonary bypass. However, the effects of diabetes on postoperative outcomes after off-pump coronary artery bypass grafting (OPCAB) are unclear. The effects of diabetes on early and mid-term results were studied by comparing the outcomes between 82 patients (65}5 years) with diabetes and 112 patients (68}11 years) without diabetes. The diabetic group included a greater preoperative presence of renal insufficiency (22.0% vs 8.9%, p0.011) and history of cerebral vascular accident (25.6% vs 11.6%, p0.012). Strategies, including graft choice, were not changed by presence of diabetes. The use of bilateral internal thoracic arteries (70.7% diabetes vs 67.0% nondiabetes), and frequency of total arterial bypass were similar in the 2 groups. The number of distal anastomoses was higher in the diabetic group (3.0}0.9 vs 2.7}0.9, p0.042). The operation time and frequency of blood transfusion were similar in both groups. There was no hospital death in either group. Although mechanical ventilation time and postoperative ICU stay did not differ, hospital stay was significantly longer in the diabetic group (16.2 vs 13.3 days, p0.0085). Postoperative major complications including atrial fibrillation were not significantly different between the 2 groups. Minor wound infection occurred in 2 patients, 1 in each group. There was no mediastinitis in either group. During the mean follow-up period of 20.8 months (1-39), there were two sudden deaths in the diabetic group, but no other cardiac death in either group. Cardiac event-free rate did not differ between the 2 groups. Although hospital stay in diabetic patients was longer than that in nondiabetic patients, early and mid-term results of OPCAB were not significantly affected by diabetes mellitus.
@Jpn. J. Cardiovasc. Surg. 35: 66-71 (2006)