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T2D ups mortality after coronary artery bypass surgery

14 Jul 2017

Type 2 diabetes mellitus (T2DM) patients have a significantly higher mortality rate following coronary artery bypass surgery (CABG) compared with those without T2DM, according to a new meta-analysis.

A meta-analysis of 11 studies (n=12,965 patients) that investigated mortality after CABG in human participants with and without T2DM found that mortality was significantly higher in T2DM patients (odds ratio [OR], 1.54; 95 percent CI, 1.37 to 1.72; p<0.00001) over a follow up of 1 to 15 years.

Results remained consistent even when considering follow-up periods of 5 to 15 (OR, 1.53; 1.36 to 1.72; p<0.00001) and 7 to 15 (OR, 1.53; 1.26 to 1.87; p<0.0001) years.

Subtype analysis with respect to type of death showed that both all-cause mortality (OR, 1.34; 1.12 to 1.60; p=0.001) and cardiac death (OR, 1.62; 1.31 to 2.00; p<0.00001) was significantly higher in T2DM patients.

Further analysis showed that short-term (1 to 5 years; OR, 1.65; 1.07 to 2.54; p=0.02), middle-term (5 to 7 years; OR, 1.53; 1.32 to 1.76; p<0.00001) and long-term mortality (7 to 15 years; OR, 1.53; 1.26 to 1.87; p<0.0001) were all significantly greater in T2DM patients.

In contrast, other adverse cardiovascular outcomes, such as myocardial infarction (OR, 1.15; 0.81 to 1.64; p=0.44), repeated revascularization (OR, 1.09; 0.88 to 1.36; p=0.43) and stroke (OR, 1.69; 0.93 to 3.07; p=0.08) were not significantly more common in T2DM patients.

The meta-analysis was performed on six randomized controlled trials (RCTs) and five observational studies retrieved from Medline, the Cochrane Library and Embase. Those with follow-up periods of <1 year, that did not report on mortality or that did not include control were excluded.

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