CORONARY-ARTERY-DISEASE AND CORONARY-ARTERY BYPASS-GRAFTING IN DIABETIC-PATIENTS AGED GREATER-THAN-OR-EQUAL-TO-65 YEARS (REPORT FROM THE CORONARY-ARTERY SURGERY STUDY [CASS] REGISTRY)

A cohort of 317 diabetic patients, aged greater than or equal to 65 ye ars, with angiographically proven coronary artery disease, was analyze d and followed for a mean of 12.8 years. compared with 1,843 age-match ed nondiabetic: patients, diabetic patients were more likely to (1) ha ve a higher number of coronary occlusions, (?) not be current smokers, (3) have higher systolic but lower diastolic blood pressures, (4) hav e evidence of peripheral vascular disease, and (5) be women. They did not differ significantly with respect to total cholesterol, family his tory of coronary artery disease, history of hypertension, or left vent ricular hypertrophy. In the total elderly cohort, diabetes was found t o be an independent predictor of mortality, conferring a 57.0% increas ed risk of death. Survival analysis showed that diabetic subjects cons istently had higher mortality than nondiabetics. However, the relative survival benefit of coronary artery bypass graft surgery versus medic al therapy was comparable in diabetic and nondiabetic patients. Surgic al therapy conferred a reduction in mortality of 44%.