Short-term outcomes following coronary artery bypass graft surgery in insulin treated and non-insulin treated diabetes: A tertiary hospital experience in Australia.

Background and Aims: Outcomes after coronary artery bypass graft (CABG) surgery have improved due to advances in surgical technique and post-operative care. We aimed to describe contemporary clinical characteristics and short-term post-operative outcomes in diabetic patients undergoing CABG surgery.

Methods: A retrospective analysis of patients who underwent CABG surgery over a 4.5-year period in a Western Australian tertiary hospital was performed in September 2019. The cohort was stratified according to pre-operative diabetes status.

Results: A total of 1327 patients underwent CABG surgery, of which 572 (43.1%) had diabetes. Diabetic patients were more likely to be female (24.7% vs. 13.9%, p < 0.001) and have dyslipidaemia (83.0% vs. 68.1%, p < 0.001), hypertension (82.0% vs. 68.7%, p < 0.001), raised body mass index (29.8 ± 5.6 vs. 28.7 ± 5.1 kg/m 2 , p < 0.001), prior myocardial infarction (62.8% vs. 54.8%, p = 0.004), prior stroke (8.6% vs. 5.0%, p = 0.010), congestive cardiac failure (20.2% vs. 15.1%, p = 0.014), reduced estimated glomerular filtration rate (86.7 ± 36.1 vs. 90.8 ± 32.1 ml/min/1.73 m 2 , p = 0.036) and three-vessel coronary artery disease (74.8% vs. 67.3%, p = 0.003). Post-operative wound infections (3.1% vs. 1.5%, p = 0.022), new dialysis requirement (2.9% vs. 1.0%, p = 0.009) and 30-day hospital admission (13.1% vs. 8.5%, p = 0.007) was more likely in diabetic patients, but not myocardial infarction (3.0% vs. 2.0%, p = 0.247), stroke (1.4% vs. 0.8%, p = 0.286) or 30-day mortality (2.4% vs. 1.7%, p = 0.354). No significant differences were detected in short-term outcomes between patients with non-insulin (n = 398) versus insulin treated (n = 174) diabetes.

Conclusions: Diabetic patients continue to represent a higher-risk cohort, highlighting the need for further strategies to reduce short-term adverse outcomes following CABG surgery.

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

(Copyright © 2020 Diabetes India. All rights reserved.)