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Szychta W, Majstrak F, Opolski G, et al. Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study. Postepy Kardiol Interwencyjnej. 2016;12(3):238-46doi: 10.5114/aic.2016.61646.
Szychta, W., Majstrak, F., Opolski, G., & Filipiak, K. J. (2016). Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study. Postepy w kardiologii interwencyjnej = Advances in interventional cardiology, 12(3), 238-46. https://doi.org/10.5114/aic.2016.61646
Szychta, Wojciech, et al. "Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study." Postepy w kardiologii interwencyjnej = Advances in interventional cardiology vol. 12,3 (2016): 238-46. doi: https://doi.org/10.5114/aic.2016.61646
Szychta W, Majstrak F, Opolski G, Filipiak KJ. Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study. Postepy Kardiol Interwencyjnej. 2016;12(3):238-46. doi: 10.5114/aic.2016.61646. Epub 2016 Aug 19. PMID: 27625687; PMCID: PMC5011540.
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Postepy Kardiol Interwencyjnej. 2016;12(3):238-46. doi: 10.5114/aic.2016.61646. Epub 2016 Aug 19.

Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study.

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

Wojciech Szychta, Franciszek Majstrak, Grzegorz Opolski, Krzysztof J Filipiak

Affiliations

  1. 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
  2. Department of Cardiac Surgery, 1 Chair of Cardiology, Medical University of Warsaw, Warsaw, Poland.

PMID: 27625687 PMCID: PMC5011540 DOI: 10.5114/aic.2016.61646

Abstract

INTRODUCTION: Strict glucose control is an everyday practice in the perioperative period. Elevated glucose level has a deleterious impact on clinical results, but a therapeutic target has not been stated yet.

AIM: To determine a glucose concentration range affecting long-term outcomes after coronary artery bypass surgery (CABG).

MATERIAL AND METHODS: This study is a retrospective evaluation of consecutive patients treated in a university hospital in Poland from 2004 to 2008. Patients were divided into 2 groups: an impaired glucose metabolism group (IGM) if they had 1) known DM or 2) perioperative hyperglycaemia defined as ≥ 200 mg/dl; and a non-IGM group. The end point (EP) was all-cause mortality.

RESULTS: One thousand two hundred and eleven patients were covered by the analysis. The observation time was from 01.01.2004 until 01.08.2012. Patients who had maximal glucose concentrations < 242 mg/dl had the lowest mortality risk (EP in 21.1%); a higher risk was noted in the group with glucose concentrations 242-324 mg/dl (EP in 30.8%); and a very high risk was found for the group where glucose concentration was > 324 mg/dl (EP in 44.2%) (p = 0.041). Patients with IGM had a shorter survival at the end of the study (p < 0.001). The longest survival was observed in patients whose maximal glucose level was ≤ 242 mg/dl (p < 0.001) and the minimal glucose concentration was in the range 61-110 mg/dl (p < 0.001).

CONCLUSIONS: Tight glucose concentration control should be performed irrespective of a diabetes diagnosis and proper treatment introduced when necessary. Maximal glucose concentration should be kept < 242 mg/dl, while the minimum should be in the range 60-110 mg/dl.

Keywords: concentration; diabetes; glucose; mortality; off-pump; off-pump coronary artery bypass surgery

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