Background and goal: Diabetes mellitus is a major health problem worldwide today with the majority of diabetics in Asia. Although diabetes has been shown to be associated with ethnicity and worse cardiac surgery outcomes, no research has been done to study the impact of both diabetes and ethnicity on cardiac surgery outcomes in a multi-ethnic Southeast Asian cohort [1]. Hence, this study aims to delineate the impact of ethnicity on outcomes after cardiac surgery among diabetics in a multi-ethnic Southeast Asian population.

Materials and Methods: We analysed data from 1231 diabetic patients undergoing elective cardiac surgery, from 2008 to 2010 at the two main heart centres in Singapore. Perioperative variables and outcomes of were compared between Chinese, Malay and Indian diabetics.

Results and Discussion: Indian diabetics tended to be heavier (70.1 ± 14.3kg, p<0.001), while Malay diabetics tended to have a higher BMI (26.5 ± 4.5, p<0.001) and preoperative renal impairment (20.9%, p=0.022) and Chinese diabetics tended to be older (62 ± 9years). 

Among diabetics, atrial fibrillation (p<0.001) and postoperative infection (p=0.035) were associated with Indian ethnicity, while acute renal failure (p=0.050), new need for dialysis (p=0.028) and 30-day mortality (p=0.003) were associated with Malay ethnicity. 

To our knowledge, this is the first such study linking different ethnicities to different adverse outcomes after cardiac surgery in the local Southeast Asian population.

Conclusion: Our study identified Indian and Malay ethnicities being associated with poorer outcomes after cardiac surgery likely due to genetic factors and other comorbidities present in each ethnic group [2]. This study also emphasizes the need for ethnic-based data unique to each population group to improve management of gene–environment interaction.

03 / ROLE OF ETHNICITY IN POORER OUTCOMES AFTER CARDIAC SURGERY IN SOUTHEAST ASIAN DIABETICS