title: Effect of diabetes on early and late survival after isolated first coronary bypass surgery in multivessel disease.
abstract: OBJECTIVE
  Diabetes has not yet been investigated as a risk factor for early and late cardiac-related death.
  
  
  METHODS
  Patients operated on from January 1988 to December 1999 were considered; 767 were diabetic (group D) and 2593 were nondiabetic (group ND). Patients with preoperative hemodynamic deterioration were excluded. Early (30-day) mortality (any causes and cardiac causes) was evaluated with univariate analysis and stepwise logistic regression. Ten-year actuarial freedom from death of any cause and cardiac death was also assessed with univariate and Cox analyses.
  
  
  RESULTS
  Early mortality was 2.2% (group D, 3.3%; group ND, 1.9%; P =.023). Early cardiac mortality was 1.3% (group D, 2.2%; group ND, 1.1%; P =.0016). Diabetes was an independent risk factor only for cardiac death and not for death of any cause. Five-year survival was 93.5% +/- 0.5% (group D, 92.5% +/- 1.1%; group ND, 93.9% +/- 0.6%; P =.0304). Diabetes was not an independent risk factor. Five-year freedom for cardiac death was 96.3% +/- 0.4% (group D, 94.9% +/- 0.9%; group ND, 96.6% +/- 0.4%; P =.0155). Diabetes was an independent risk factor. However, if only the patients who survived the first 30 days are considered, diabetes disappears as a risk factor (5-year freedom for cardiac death, 97.8% +/- 0.3%; group D, 97.3% +/- 0.8%; group ND, 97.9% +/- 0.4%; P = 0.2389).
  
  
  CONCLUSIONS
  Diabetes is an independent risk factor for early cardiac death only. Long-term survival in patients who survive the first 30 days is not statistically significantly different for diabetic and nondiabetic patients. In fact, the rates appear very similar.
authors.affiliation: Department of Cardiology and Cardiac Surgery, University "G. D'Annunzio," Chieti, Italy.
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Calafiore
authors.forename: Michele
authors.initials: M
authors.lastname: Di Mauro
authors.forename: Gabriele
authors.initials: G
authors.lastname: Di Giammarco
authors.forename: Marco
authors.initials: M
authors.lastname: Contini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vitolla
authors.forename: Angela Lorena
authors.initials: AL
authors.lastname: Iacò
authors.forename: Carlo
authors.initials: C
authors.lastname: Canosa
authors.forename: Stefano
authors.initials: S
authors.lastname: D'Alessandro
mesh_terms: D000206:Actuarial Analysis; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000401:mortality*; D003327:Coronary Disease / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors