Diabetic control and coronary artery bypass: Effect on short-term outcomes

Stephen Strahan, Ryan M Harvey, Andrew Campbell-Lloyd, Elaine Beller, Julie Mundy, Pallav Shah

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Abstract

AIM: To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting.

METHODS: Data of 3857 patients undergoing primary coronary artery bypass grafting was prospectively collected and retrospectively analyzed. There were 1109 (29%) diabetic patients, of whom 712 (64%) had hemoglobin A1c levels recorded. They were categorized by diabetic treatment: diet (179), oral hypoglycemic agent, (718) or insulin (212); and by diabetic control: hemoglobin A1c < 7 (265) or ≥7 (447). Nondiabetic patients (2,748) were used as controls.

RESULTS: The preoperative risk factors of hypertension (p < 0.001), hyperlipidemia (p < 0.001), renal failure (p < 0.04), peripheral vascular disease (p < 0.001), and chronic obstructive pulmonary disease (p < 0.04) were significantly more prevalent in diabetic patients. Major complications were not significantly different between the diabetic and control groups (p = 0.33), but minor complications were less frequent in diabetic patients (p = 0.03). Major and minor complications were not significantly different among the treatment subgroups of diabetic patients (p = 0.74 and p = 0.48) or in those with hemoglobin A1c < 7 and ≥7 (p = 0.23, p = 0.41).

CONCLUSIONS: Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.

Original languageEnglish
Pages (from-to)281-7
Number of pages7
JournalAsian Cardiovascular and Thoracic Annals
Volume21
Issue number3
DOIs
Publication statusPublished - Jun 2013

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Coronary Artery Bypass
Hemoglobins
Diabetic Diet
Perioperative Period
Peripheral Vascular Diseases
Hospital Mortality
Hyperlipidemias
Hypoglycemic Agents
Chronic Obstructive Pulmonary Disease
Renal Insufficiency
Therapeutics
Insulin
Hypertension
Morbidity
Control Groups

Cite this

Strahan, Stephen ; Harvey, Ryan M ; Campbell-Lloyd, Andrew ; Beller, Elaine ; Mundy, Julie ; Shah, Pallav. / Diabetic control and coronary artery bypass : Effect on short-term outcomes. In: Asian Cardiovascular and Thoracic Annals. 2013 ; Vol. 21, No. 3. pp. 281-7.
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abstract = "AIM: To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting.METHODS: Data of 3857 patients undergoing primary coronary artery bypass grafting was prospectively collected and retrospectively analyzed. There were 1109 (29{\%}) diabetic patients, of whom 712 (64{\%}) had hemoglobin A1c levels recorded. They were categorized by diabetic treatment: diet (179), oral hypoglycemic agent, (718) or insulin (212); and by diabetic control: hemoglobin A1c < 7 (265) or ≥7 (447). Nondiabetic patients (2,748) were used as controls.RESULTS: The preoperative risk factors of hypertension (p < 0.001), hyperlipidemia (p < 0.001), renal failure (p < 0.04), peripheral vascular disease (p < 0.001), and chronic obstructive pulmonary disease (p < 0.04) were significantly more prevalent in diabetic patients. Major complications were not significantly different between the diabetic and control groups (p = 0.33), but minor complications were less frequent in diabetic patients (p = 0.03). Major and minor complications were not significantly different among the treatment subgroups of diabetic patients (p = 0.74 and p = 0.48) or in those with hemoglobin A1c < 7 and ≥7 (p = 0.23, p = 0.41).CONCLUSIONS: Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.",
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Diabetic control and coronary artery bypass : Effect on short-term outcomes. / Strahan, Stephen; Harvey, Ryan M; Campbell-Lloyd, Andrew; Beller, Elaine; Mundy, Julie; Shah, Pallav.

In: Asian Cardiovascular and Thoracic Annals, Vol. 21, No. 3, 06.2013, p. 281-7.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Diabetic control and coronary artery bypass

T2 - Effect on short-term outcomes

AU - Strahan, Stephen

AU - Harvey, Ryan M

AU - Campbell-Lloyd, Andrew

AU - Beller, Elaine

AU - Mundy, Julie

AU - Shah, Pallav

PY - 2013/6

Y1 - 2013/6

N2 - AIM: To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting.METHODS: Data of 3857 patients undergoing primary coronary artery bypass grafting was prospectively collected and retrospectively analyzed. There were 1109 (29%) diabetic patients, of whom 712 (64%) had hemoglobin A1c levels recorded. They were categorized by diabetic treatment: diet (179), oral hypoglycemic agent, (718) or insulin (212); and by diabetic control: hemoglobin A1c < 7 (265) or ≥7 (447). Nondiabetic patients (2,748) were used as controls.RESULTS: The preoperative risk factors of hypertension (p < 0.001), hyperlipidemia (p < 0.001), renal failure (p < 0.04), peripheral vascular disease (p < 0.001), and chronic obstructive pulmonary disease (p < 0.04) were significantly more prevalent in diabetic patients. Major complications were not significantly different between the diabetic and control groups (p = 0.33), but minor complications were less frequent in diabetic patients (p = 0.03). Major and minor complications were not significantly different among the treatment subgroups of diabetic patients (p = 0.74 and p = 0.48) or in those with hemoglobin A1c < 7 and ≥7 (p = 0.23, p = 0.41).CONCLUSIONS: Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.

AB - AIM: To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting.METHODS: Data of 3857 patients undergoing primary coronary artery bypass grafting was prospectively collected and retrospectively analyzed. There were 1109 (29%) diabetic patients, of whom 712 (64%) had hemoglobin A1c levels recorded. They were categorized by diabetic treatment: diet (179), oral hypoglycemic agent, (718) or insulin (212); and by diabetic control: hemoglobin A1c < 7 (265) or ≥7 (447). Nondiabetic patients (2,748) were used as controls.RESULTS: The preoperative risk factors of hypertension (p < 0.001), hyperlipidemia (p < 0.001), renal failure (p < 0.04), peripheral vascular disease (p < 0.001), and chronic obstructive pulmonary disease (p < 0.04) were significantly more prevalent in diabetic patients. Major complications were not significantly different between the diabetic and control groups (p = 0.33), but minor complications were less frequent in diabetic patients (p = 0.03). Major and minor complications were not significantly different among the treatment subgroups of diabetic patients (p = 0.74 and p = 0.48) or in those with hemoglobin A1c < 7 and ≥7 (p = 0.23, p = 0.41).CONCLUSIONS: Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.

U2 - 10.1177/0218492312451983

DO - 10.1177/0218492312451983

M3 - Article

VL - 21

SP - 281

EP - 287

JO - Asian Cardiovascular and Thoracic Annals

JF - Asian Cardiovascular and Thoracic Annals

SN - 0218-4923

IS - 3

ER -