Race and Survival among Diabetic Patients after Coronary Artery Bypass Grafting

Wesley T. O'Neal; Jimmy T. Efird; Stephen W. Davies; Jason B. O'Neal; Curtis A. Anderson; W. Randolph Chitwood; T. Bruce Ferguson; Alan P. Kypson

doi:10.1055/s-0033-1357297

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2014; 62(04): 308-316
DOI: 10.1055/s-0033-1357297

Original Cardiovascular

Georg Thieme Verlag KG Stuttgart · New York

Race and Survival among Diabetic Patients after Coronary Artery Bypass Grafting

Wesley T. O'Neal

¹Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina

,

Jimmy T. Efird

²Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina

³Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina

,

Stephen W. Davies

⁴Department of General Surgery, University of Virginia School of Medicine, Charlottesville, Virginia

,

Jason B. O'Neal

⁵Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

,

Curtis A. Anderson

²Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina

,

W. Randolph Chitwood

²Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina

,

T. Bruce Ferguson

²Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina

,

Alan P. Kypson

²Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, North Carolina

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Abstract

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Abstract

Background Diabetes is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined.

Methods A retrospective cohort study was conducted for CABG patients between 1992 and 2011. Long-term survival was compared in patients with and without diabetes and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.

Results Out of the 13,053 patients undergoing CABG, 35% (black n = 1,655; white n = 2,884) had diabetes at the time of surgery. The median follow-up for study participants was 8.2 years. Long-term survival after CABG was similar between black and white diabetic patients (no diabetes, HR = 1.0; white diabetic patients, adjusted HR = 1.5, 95%CI = 1.4–1.6; black diabetic patients, adjusted HR = 1.5, 95%CI = 1.4–1.7).

Conclusion A survival disadvantage after CABG was not observed among black versus white diabetic patients in our study.

Keywords

diabetes - CABG - outcomes - epidemiology

Volltext

Referenzen

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