Is Diabetic Nephropathy a Predicted Risk Factor? : Kaplan-Meier and Multivariate Analysis of Confounding Risk Factors in Off-Pump Coronary Artery Bypass Grafting for Chronic Dialysis Patients

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Background: The purpose of this study was to investigate the preoperative risk factors of performing off-pump coronary artery bypass grafting (OPCAB) in patients on chronic dialysis. Methods and Results: The 41 consecutive patients on chronic dialysis who underwent OPCAB from February 2000 to April 2006 at the National Cardiovascular Center were studied retrospectively. Of them, 29 had diabetic nephropathy (DN group) and the remaining 12 did not (NDN group). There were significant differences in the duration of dialysis before surgery (9.1 ±7.5 years in NDN vs 4.2 ±5.5 years in DN, P=0.028) and low cardiac function (left ventricular ejection fraction <30%), which was recognized only in the DN group (7/29, P=0.048). The early mortality rate was 6.9% (2/29) in the DN group and 16.7% (2/12) in the NDN group (P=0.349). The actuarial survival rates in the DN group were 85% at 1 year, 45% at 3 years, and 30% at 5 years, whereas in the NDN group they were 71%, 49%, and 49%, respectively (P=0.789). Arteriosclerosis obliterans (ASO) and age (>65 years) were independent risk factors of late death. Conclusions: For patients on chronic dialysis ASO and aging were predicted risk factors for OPCAB, whereas diabetic nephropathy was not.
2009-10-20