Impact of Periprocedural Risk Predictors on Long-Term Outcomes in Patients with Diabetes Undergoing Coronary Artery Bypass Grafting

Background and Objectives: In this study, we aim to analyze the impact of risk predictors on long-term outcomes in patients with diabetes undergoing isolated coronary artery bypass grafting (CABG). Materials and Methods: All consecutive patients undergoing isolated CABG between May 2005 and June 2021 were included in the study. Patients with and without diabetes were compared for baseline demographics and pre-operative characteristics. A propensity-matched analysis was used to compare the two groups. The primary outcome was long-term incidence of all-cause death. Results: Of a total of 4871 patients, propensity matching identified 1589 pairs of patients with and without diabetes that were included in the current study. Median follow-up was 5.8 years. All-cause death was recorded in 215/1589 (13.5%) vs. 169/1589 (10.6%) patients with and without diabetes, respectively (HR 1.3, p = 0.013). MACCE was also significantly higher in diabetic patients (HR 1.3, p = 0.049). Diabetes mellitus was identified as one of the independent predictors for all-cause mortality (HR 1.4, CI 1.2, 1.7) and MACCE (HR 1.2, CI 1.0, 1.3). Chronic obstructive pulmonary disease, peripheral vascular disease, and serum creatinine levels >2.0 mg/dL were found to be the only predictors of all-cause mortality in both diabetic and non-diabetic patient groups, when individually analyzed. Conclusions: Patients with diabetes undergoing isolated CABG had a significantly higher incidence of late all-cause death and MACCE compared to those without diabetes. The presence of diabetes mellitus predicts poorer long-term outcomes following CABG.