- Paper Report
- Open Access
'No independent link' between diabetes and poor outcomes after CABG/PTCA
- Joanna Lyford1
© Biomed Central Ltd 2001
- Received: 19 October 2001
- Published: 19 October 2001
- Diabetes, outcome, revascularization
An investigation into why diabetic patients have worse outcomes than nondiabetics after cardiac catheterization reveals that the discrepancy can be entirely explained by adverse clinical variables that are associated with diabetes. Contradicting previous studies, Canadian researchers identified no 'independent diabetes factor' - such as an increased tendency towards thrombosis - that was independently associated with worse mortality following revascularization procedures.
The team reports that unadjusted 1-year mortality was 7.6% for patients with diabetes versus 4.1% for those without diabetes (odds ratio 1.9, 95% confidence interval [CI] 1.6-2.3). However, after adjusting for potential confounders including comorbid conditions, previous cardiac history, coronary anatomy and renal function, the odds ratio was reduced to 1.1 (95% CI 0.8-1.3). Similarly, the adjusted hazard ratio for longer term mortality was 1.2 (95% CI 1.0-1.4, mean follow-up 702 days).
A multicenter team analyzed data from a prospective cohort study (APPROACH) that captured detailed clinical information and longitudinal outcomes for 11,468 patients (17% of whom were diabetic) undergoing cardiac catheterization in Alberta, Canada. They used logistic regression to model predictors of 1-year mortality, while proportional hazards analysis was used to model predictors of survival up to 3 years after cardiac catheterization.