Background:
We performed a nationwide population-based cohort study to investigate the long-term risk of stroke after coronary artery bypass grafting (CABG) in patients with type 1 and type 2 diabetes.
Hypothesis:
Type 1 and type 2 diabetes is associated with an increased longterm risk of stroke after CABG.
Methods and Results:
All patients who underwent primary CABG in Sweden from 2000 through 2011 were included from the SWEDEHEART register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all-cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. A total of 53 820 patients (type 1 diabetes (n=714), type 2 diabetes (n=10 054), no diabetes (n=43 052)) were included. During a mean follow-up of 7.4 years (398 337 person-years), in total, 8.0% (n=4 296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3 329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% confidence interval) for all stroke was 1.59 (1.20-2.11) in type 1 diabetes, and 1.32 (1.23-1.43) in type 2 diabetes compared to patients without diabetes. Figure 1 shows the age-adjusted cumulative incidence of stroke in relation to type 1 diabetes, type 2 diabetes and no diabetes.
Conclusions:
The long-term risk for stroke after CABG was higher in both patients with type 1 diabetes, and type 2 diabetes, compared to patients without diabetes.
Neuropsychological dynamics in patients with type 2 diabetes mellitus undergone coronary artery bypass grafting
