title: Impact of diabetes on mortality and complications after coronary artery by-pass graft operation in patients with left main coronary artery disease.
abstract: OBJECTIVE
  Left main disease (LMD) is a severe form of coronary artery disease (CAD). Fifty percent of patients with LMD treated conservatively die within 3-5 years of diagnosis. The aim of the study was to assess the influence of type 2 diabetes on early and late (2-year) prognosis and the risk of complications after coronary artery by-pass graft (CABG) surgery in patients with LMD.
  
  
  METHODS
  We enrolled 257 patients diagnosed with LMD. 169 (67%) underwent CABG, 19 (8%) percutaneous coronary intervention (PCI) without left main stem protection. 30 (12%) patients had CABG previously. Patients treated with CABG were divided into two groups - with and without diabetes. There were 43 (25.4%) patients with diabetes and 126 (74.6%) without diabetes.
  
  
  RESULTS
  We observed more complications with wound healing (40.5% vs. 12.8%, p<0.001) and sternal dehiscence (23.8% vs. 4.0%, p<0.001) after CABG in patients with diabetes. There were no differences in 7-day, 30-day, 3-month and 1-year mortality. 2-Year mortality was also similar in both groups (11.6% vs. 11.1%, p=0.928). Patients with diabetes were more frequently hospitalized due to other reasons than angina (39.5% vs. 20.6%, p=0.014).
  
  
  CONCLUSIONS
  Patients with diabetes and LMD had more often complications with wound healing and sternal dehiscence after CABG than patients without diabetes. Type 2 diabetes did not influence early and late mortality in patients with LMD treated with cardiac surgery, but the presence of diabetes was associated with more frequent hospitalizations.
authors.affiliation: Department of Invasive Cardiology, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Zalewska-Adamiec
authors.affiliation: Department of Invasive Cardiology, Medical University in Bialystok, Bialystok, Poland; Department of Clinical Medicine, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Bachorzewska-Gajewska
authors.affiliation: Department of Nephrology, Transplantation with Dialysis Center, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Malyszko
authors.affiliation: Department of Cardiology, Medical University in Bialystok, Bialystok, Poland. Electronic address: walkaz@poczta.fm.
authors.forename: Anna
authors.initials: A
authors.lastname: Tomaszuk-Kazberuk
authors.affiliation: Department of Invasive Cardiology, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Nowak
authors.affiliation: Department of Cardiac Surgery, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Hirnle
authors.affiliation: Department of Invasive Cardiology, Medical University in Bialystok, Bialystok, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Dobrzycki
mesh_terms: D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
keywords: Coronary artery by-pass graft surgery; Diabetes; Left main coronary artery disease