Abstract 2303: The Short-term Benefits of Off-pump Coronary Artery Bypass for Diabetes Patients Disappears in the Long Run
Numerous studies revealed the adverse impacts of diabetes on the outcomes of coronary artery bypass grafting (CABG). However, the disparities of impacts of different surgical techniques on the prognosis of diabetes and non-diabetes patients were still unknown. The objective of this study was to evaluate the possible beneficial effects of off-pump CABG (OPCAB) on the immediate as well as long term postoperative outcomes. From 1999 to 2005, 5550 consecutive patients underwent isolated conventional CABG (cCABG) or OPCAB in our institute. All patients have finished a 3-year follow up. In-hospital MACE includes cardiac death, stroke and myocardial infarction. As for MACE in the follow-up, the definition was the combination of cardiac death, stroke, myocardial infarction and revascularization. These data were prospectively collected and retrospectively reviewed. After risk adjustment, diabetes patients in cCABG group had an OR of 1.385 (p<0.001) for immediate mortality and 1.291 (p<0.010) for immediate MACE comparing with non-diabetes patients receiving cCABG. On the contrary, no significant differences were found when comparisons between diabetes and non-diabetes patients undergoing OPCAB were carried out, indicating beneficial effects of OPCAB for diabetes patients in short terms. However, while the risk-adjusted HR of diabetes patients for long-term mortality and for long-term MACE in cCABG group were 1.130 (p=0.003) and 1.781 (p=0.001) respective, those in OPCAB group were 1.082 (p=0.077) and 1.038 (p<0.001). These results suggested that although the beneficial effects of OPCAB for diabetes patients in terms of mortality still remained, those in terms of long-term MACE disappeared. Although reductions of differences of in-hospital adverse outcomes between diabetes and non-diabetes patients undergoing OPCABG were seen, these beneficial effects were mitigated in the long run.