Preoperative diabetic duration and long-term outcomes in acute myocardial infarction patients undergoing coronary artery bypass grafting

초록

BACKGROUND: The association between preoperative diabetes mellitus (DM) duration and outcomes of coronary artery bypass grafting (CABG) remains unclear. This study aimed to investigate the relationship between DM duration at the time of CABG and long-term outcomes, particularly patients with acute myocardial infarction (AMI). METHODS: Using data from South Korea's National Health Insurance Service database, the study included adult patients who underwent first-time isolated CABG with an AMI diagnosis between 2005 and 2021. DM patients were categorized based on whether their diagnosis occurred within 5 years before CABG. Patients with impaired fasting glucose were also classified. The primary outcome was all-cause overall mortality. The secondary outcome was repeat revascularization. RESULTS: A total of 21,957 patients (median age, 65.0 years) were categorized into four groups: without DM, impaired fasting glucose, DM diagnosed within 5 years, and DM diagnosed more than 5 years before CABG. Patients with DM for less than 5 years had a higher overall mortality rate (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.08-1.24), and those with DM for more than 5 years had an even higher rate (HR, 1.36; 95% CI, 1.27-1.46) compared to those without DM. The incidence rate of repeat revascularization was significantly higher in those with DM for more than 5 years (HR, 2.07; 95% CI, 1.89-2.28). CONCLUSIONS: The duration of DM prior to CABG is correlated with worse clinical outcomes. A prolonged period of DM before CABG may be a significant risk factor for poorer long-term outcomes in AMI patients. Copyright © 2025. Published by Elsevier Inc.

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