Long-Term Nitrogen Dioxide Exposure as a Possible 5-Year Mortality Risk Factor in Diabetic Patients Treated Using Off-Pump Surgical Revascularization—A Retrospective Analysis

<i>Background</i>: There is mounting evidence that diabetic-related cardiac metabolism abnormalities with oxidative stress and inflammatory mechanism activation align with the functional impairments that result in atherosclerotic lesion formation. Among the possible non-traditional coronary lesion risk factors, environmental exposure may be significant, especially in diabetic patients. <i>Methods</i>: A total of 140 diabetic patients (115 (82%) males and 25 (18%) females) with a mean age of 65 (60-71) underwent surgical revascularization due to multivessel coronary disease. The possible all-cause mortality risk factors, including demographical and clinical factors followed by chronic air pollution exposure, were identified. <i>Results</i>: All patients were operated on using the off-pump technique and followed for 5.6 (5-6.1) years. The multivariable model for 5-year mortality prediction presented the nitrogen dioxide chronic exposure (HR: 3.99, 95% CI: 1.16-13.71, <i>p</i> = 0.028) and completeness of revascularization (HR: 0.19, 95% CI: 0.04-0.86, <i>p</i> = 0.031) as significant all-cause mortality risk factors. <i>Conclusions</i>: Ambient air pollutants such as an excessive chronic nitrogen dioxide concentration (>15 µg/m³) may increase 5-year all-cause mortality in diabetic patients following surgical revascularization.