Coronary artery bypass grafting in diabetics: A growing health care cost crisis Sajjad Raza, MD, Joseph F. Sabik, MD, Ponnuthurai Ainkaran, MS, Eugene.

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Coronary artery bypass grafting in diabetics: A growing health care cost crisis Sajjad Raza, MD, Joseph F. Sabik, MD, Ponnuthurai Ainkaran, MS, Eugene H. Blackstone, MD The Journal of Thoracic and Cardiovascular Surgery Volume 150, Issue 2, Pages 304-312.e2 (August 2015) DOI: 10.1016/j.jtcvs.2015.03.041 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Four-decade trends in prevalence of diabetes and cardiovascular risk factors among patients undergoing primary isolated coronary artery bypass grafting. Each circle is a yearly percentage or mean value, and solid lines are loess estimates. The factors shown are: (A) age; (B) body mass index; (C) stroke; (D) hypertension; (E) PAD; (F) total cholesterol; (G) HDL cholesterol; (H) triglycerides; and (I) percentage with 3-system disease. PAD, Peripheral arterial disease; HDL, high-density lipoprotein. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Median (triangles) ratio of total direct technical costs (overall and propensity matched) in diabetics versus nondiabetics. Error bars are 95% confidence intervals. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Time-related death after primary isolated coronary artery bypass grafting in diabetics and nondiabetics. Solid lines are parametric estimates enclosed within dashed 68% confidence bands equivalent to ±1 SE. The panels show: (A) instantaneous risk of death (overall); (B) survival (overall); (C) instantaneous risk of death (propensity-matched cohort); and (D) survival (propensity-matched cohort). Each symbol represents a death; vertical bars are confidence limits equivalent to ±1 SE; and values in parentheses are numbers of patients remaining at risk. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Four-decade trend in prevalence of diabetes among patients undergoing primary isolated coronary artery bypass grafting. Each circle represents a yearly percentage, and the solid line is the locally estimated scatterplot smoother (loess) estimate. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Mirrored histogram of distribution of propensity scores for diabetes and no diabetes (shaded area represents matched patient cohorts). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Covariable balance plot before and after propensity-score matching on selected covariables (Austin PC, Mamdani MM. A comparison of propensity score methods: a case study estimating the effectiveness of post-AMI statin use. Stat Med. 2006;25:2084-106.) Diabetes-like characteristics are on the right; non–diabetes-like characteristics are on the left. BMI, Body mass index; LV, left ventricular; PAD, peripheral arterial disease; MI, myocardial infarction; NYHA, New York Heart Association; STD, standardized. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 304-312.e2DOI: (10.1016/j.jtcvs.2015.03.041) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions