Dorothea Jasniak
Ischaemic heart disease accounts for 75% of deaths among diabetics. While the influence of diabetes on coronary artery bypass surgery mortality is recognised, the impact on other post-operative outcomes is less well researched.
The aim of this study was to compare mortality between non-diabetic, insulin-dependent, tablet- and diet-controlled diabetic patients as well as investigate diabetes´ influence on postoperative arrhythmias.
Diabetic patients were more likely to have hypertension, urgent surgeries, recent MIs, renal dysfunction, extracardiac arteriopathies, and previous cardiac surgeries. Insulin-dependent patients were significantly younger and less frequently female. Short-term mortality was comparable across all groups, as was long-term mortality between nondiabetics and non-insulin-dependent diabetics. IDDM patients showed significantly higher long-term mortality compared to nondiabetics. Postoperative arrhythmia was significantly less frequent in insulin-dependent and tablet-controlled diabetics compared with the other groups. Contrastingly, diet-controlled diabetics more often experienced both presurgical and postoperative arrhythmias than non-diabetic patients, although the lack of significant deviation for postoperative frequency needs to be noted.
While this study cannot prove whether diabetes is an independent predictor of CABG mortality, it underlines the heightened risk both insulin-dependent and non-insulin-dependent patients experience. It emphasizes the need for preoperative glycaemic control strategies adjusted to the diabetes type and postoperative long-term management.