Diabetes does not influence long-term bypass graft patency
It appears that diabetes does not confer any effect on long-term patency of bypass grafts, a recent study has found.
“Use of internal thoracic artery (ITA) grafts should be maximized in patients undergoing coronary artery bypass grafting because they have excellent patency in patients with and without diabetes even after 20 years,” researchers said.
A total of 57,961 patients underwent primary isolated coronary artery bypass grafting from 1972 to 2011. Of these, 1,372 pharmacologically treated patients with diabetes and 10,147 patients without diabetes had 15,887 postoperative angiograms; stenosis was quantified for 7,903 and 20,066 ITA grafts and saphenous vein grafts, respectively.
Researchers analysed the status of graft patency across time using longitudinal nonlinear mixed-effects modeling.
Patency of ITA graft remained stable over time and were similar in patients with and without diabetes: 97, 97, 96 and 96 percent in patients with diabetes, and 96, 96, 95 and 93 percent in patients without diabetes at 1, 5, 10 and 20 years, respectively (early p=0.20; late p=0.30).
On the other hand, patency of saphenous vein graft declined over time and similarly in patients with and without diabetes: 78, 70, 57 and 42 percent in patients with diabetes, and 82, 72, 58 and 41 percent in patients without diabetes at 1, 5, 10 and 20 years, respectively (early p<0.002; late p=0.60).
Adjustment for patient characteristics revealed an association between diabetes and higher early patency of ITA grafts (odds ratio, 0.63; 95 percent CI, 0.43 to 0.91; p=0.013). However, late patency of ITA grafts was comparable in patients with and without diabetes (early p=0.90; late p=0.80).
According to researchers, about half of patients undergoing coronary artery bypass grafting have diabetes.