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

• Main Authors: Wojciech Szychta, Franciszek Majstrak, Grzegorz Opolski, Krzysztof J. Filipiak
• Format: Article
• Language: English
• Published: Termedia Publishing House 2016-08-01
• Series: Advances in Interventional Cardiology
• Subjects: diabetes; concentration; glucose; mortality; off-pump coronary artery bypass surgery; off-pump
• Online Access: https://www.termedia.pl/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,35,28121,1,1.html
• ISSN: 1734-9338; 1897-4295

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 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.