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Are even impaired fasting blood glucose levels preoperatively associated with increased mortality after CABG surgery?

R E Anderson1, K Klerdal, T Ivert

  • 1Department of Cardiothoracic Surgery and Anaesthesiology, Karolinska University Hospital, S-171 76 Stockholm, Sweden. russell.anderson@kirurgi.ki.se

European Heart Journal
|April 1, 2005
PubMed

Insights

Elevated fasting blood glucose, including impaired fasting glucose (IFG) and undiagnosed diabetes, is linked to higher mortality after coronary artery bypass grafting (CABG). This risk mirrors that of patients with diagnosed diabetes, highlighting the importance of glucose management.

Area of Science:

  • Cardiology
  • Endocrinology
  • Surgical Outcomes

Background:

  • Impaired fasting glucose (IFG) is linked to macrovascular issues and mortality post-percutaneous coronary interventions.
  • Pre-operative glucose levels are crucial for assessing surgical risk in cardiac patients.

Purpose of the Study:

  • To investigate the association between pre-operative fasting blood glucose (fB-glu) and mortality following coronary artery bypass grafting (CABG).

Main Methods:

  • Analysis of 1895 patients undergoing primary CABG between 2001-2003.
  • Categorization of non-diabetic patients based on pre-operative fB-glu: normal (<5.6 mmol/L), IFG (5.6-6.1 mmol/L), and suspected diabetes (SDM) (≥6.1 mmol/L).
  • Comparison of 30-day and 1-year mortality rates across glucose categories.

Main Results:

  • 59% of patients had normal pre-operative fB-glu.
  • IFG was associated with a 1.7-fold risk of 30-day mortality and a 2.9-fold risk of 1-year mortality compared to normal glucose.
  • Suspected diabetes (SDM) showed a 2.8-fold risk of 30-day mortality and a 1.9-fold risk of 1-year mortality.
  • The receiver operator characteristic analysis indicated fB-glu is a significant predictor of 1-year mortality (area=0.65, P=0.002).

Conclusions:

  • The increased mortality risk observed in patients with diagnosed diabetes mellitus (CDM) after CABG is also present in patients with IFG and undiagnosed diabetes.
  • Pre-operative glucose assessment, beyond diagnosing diabetes, is vital for risk stratification in CABG patients.
Abstract

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