Mid-term Outcome and Prognosis of Prediabetic Patients After Coronary Artery Bypass Graft Surgery, Regardless of the First Month After Surgery

摘要

Objective: Current knowledge of the effects of prediabetes on the postsurgical outcomes of mortality and major adverse cardiovascular events (MACE) after coronary artery bypass graft surgery (CABG) is limited. The aim of this study is to evaluate the MACE and overall 1-year survival of patients with prediabetes who underwent elective isolated CABG. Material and Methods: After a thorough analysis of CABG database since January 2016, 3741 patients were included. Patients were categorized as follows: diabetes mellitus type 2 (n=2695), prediabetics (fasting blood sugar = 100-125 mg/dL and hemoglobinAlc (HbA1c) = 5.7%-6.4%) (n=471), andnondiabetics (fasting blood sugar <100mg/dL and HbA1c < 5.7%) (n = 575). Primary end point (MACE) was the composite death, acute coronary syndrome, coronary revascularization, and cerebrovascular events after 1 month of surgery. Event-free survival was assessed and compared between groups over a median follow-up of 1 year. Results: In this retrospective cohort design, 3741 patients who underwent elective isolated CABG were evaluated. One-year overall survival percent was 100% for nondiabetic and prediabetic patients and 99.9% for diabetic patients (P value = 0.56). One-year event-free survival was 97.4% for nondiabetics, 98.1% for prediabetics, and 96.8% for diabetic patients (P value = 0.08). Conclusions: One-year overall survival and also the event-free survival of prediabetic patients were similar to those without diabetes mellitus. Over the median follow-up of 1 year, descending trends shows the higher probability of adverse events in diabetic patients with longer follow-ups.