title: Similar outcome in insulin-dependent and noninsulin-dependent diabetic patients after off-pump coronary artery bypass grafting with multiple skeletonized arterial conduits.
abstract: BACKGROUND
  We were interested in whether current multiarterial off-pump coronary artery bypass graft surgery can improve the clinical outcome for insulin-dependent diabetes mellitus patients.
  
  
  METHODS
  Between January 2002 and December 2013, 1,064 consecutive patients underwent isolated off-pump coronary artery bypass surgery at our hospital; 551 of these patients had diabetes. Of these 551 patients, 166 had insulin-dependent diabetes (IDM) and the remaining 385 had noninsulin-dependent diabetes (NIDM). The propensity score was calculated to achieve one-to-two matching sets (IDM 143 versus NIDM 286).
  
  
  RESULTS
  Ten patients (3.5%) in the NIDM group and 2 patients (1.4%) in the IDM group died in hospital (p = 0.18). Insulin dependency was not an independent risk factor for any early death or major complications. Follow-up was complete for 96.5% of the patients, with a mean follow-up of 4.6 ± 3.8 years. Overall survival rate at 10 years was 76.3% for the NIDM group and 73.1% for the IDM group (p = 0.79). The rate of 10-year actuarial freedom from major adverse cardiac events was 89.6% in the NIDM group and 86.3% in the IDM group (p = 0.72). Multivariate Cox proportional hazard regression analysis revealed that female sex, congestive heart failure, previous myocardial infarction, lower ejection fraction, and at least one major complication were independent risk factors for combined cardiac events. Insulin dependency did not affect any outcome in the long term.
  
  
  CONCLUSIONS
  Early and long-term outcomes after off-pump skeletonized multiarterial coronary artery bypass graft surgery were similar among the IDM and NIDM patients.
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan. Electronic address: suzukit@belle.shiga-med.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Asai
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Nota
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Fujino
authors.affiliation: Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takashima
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome