People with diabetes who undergo heart bypass surgery live a little longer if surgeons use arteries rather than veins for the operatio, new research finds.
The study, which was published in The Annals of Thoracic Surgery journal, showed there were also fewer long-term complications when only arteries are used for bypasses during coronary artery bypass grafting (CABG) surgery.
Dr James Tatoulis, from the Royal Melbourne Hospital in Australia, where the research was carried out, said: “Going into this study, we believed that diabetic patients would do better using total arterial techniques. But it was gratifying to actually prove it and also be able to document the significant magnitude of the difference.”
More than 63,000 cardiac surgical cases from the Australian and New Zealand Society of Cardiothoracic Surgeons (ANZSCTS) Database took part in the study.
A total of 34,181 people underwent CABG surgery for the first time.
Artery-only surgery (known as total arterial revascularization or TAR) was carried out on 2,017 people with diabetes whereas 1,967 people with diabetes underwent the more conventional CABG surgery, using veins.
The findings suggested that long-term survival rates improved significantly when either TAR or CABG surgery is carried out on people with diabetes. Survival rates were reviewed after one, five and 10 years and the results showed better survival associated with TAR compared with standard CABG, suing veins, across each of these periods.
Researchers also discovered that these forms of surgery were not associated with an increase in the rate of complications such as angina (chest pain), heart attacks, heart failure and hospital readmissions.
The American Heart Association said there has always been a strong link between coronary artery disease (CAD) and diabetes.
The organisation estimates that adults who have diabetes are up to four times more likely to have heart disease than those who do not have the condition.
Tatoulis said: “With the incidence of diabetes increasing in the United States, happening together with the continued improvement in life expectancy, it is probable that there will be more and more diabetic patients requiring CABG surgery in the future. Thus, the superiority of (total arterial revascularisation (TAR) [or] CABG will assume progressive importance.”
For more than 50 years CABG surgery has been carried out. The US Centres for Disease Control and Prevention said almost 400,000 CABG surgeries are performed each year.
CABG surgery is designed to help restore blood flow to the hearts of patients with coronary artery disease, which is caused by a build-up of calcium, fat and cholesterol.
The researchers concluded: “These findings will gain increasing importance with the progressive longevity of the population and the increasing proportion of diabetic patients who may require CABG.”

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