Survival of Multiple Arterial Grafting in Diabetic Populations: A Twenty-Year National Experience

Structured abstract Objectives Diabetics may have diminished survival after coronary artery bypass grafting even with multiple arterial revascularization. We compared multi-arterial versus single-arterial grafting survival in diabetic and non-diabetic patients undergoing primary isolated bypass surgery. Methods This is a retrospective analysis of the Australian and New Zealand Society of Cardiac-Thoracic Surgical Database from June 2001 to January 2020. Patients were classified as having either single or multiple arterial grafting irrespective of the number of venous grafts. The end-points were long-term all-cause mortality and 30-day clinical outcomes, which was compared in 1:1 propensity score matched patients. Cox regression model was used to assess interactions between diabetes and the treatment effect of multi-arterial grafting, reported as hazard ratios and confidence intervals. Short-term outcomes were compared with McNemar’s paired t-test. Results From 69,624 patients, matching generated 17,474 non-diabetic and 10,989 diabetic patient pairs. At a median [interquartile range] of 5.9 [3.2–9.6] years postoperative, mortality was significantly lower after multi-arterial grafting for both diabetic (hazard ratio, 0.83; 95% confidence interval, 0.76–0.90, P Conclusions Multi-arterial grafting was associated with improved overall survival compared to single arterial grafting for both non-diabetic and diabetic patients.