Risk of Death After Bypass Surgery Increases For Pre Diabetics

Individuals with impaired fasting glucose levels are at increased risk of death after coronary artery bypass grafting.

While it’s well known that diabetic patients have an elevated risk of death after CABG, less is known about the risks incurred by individuals with impaired fasting glucose below the diagnostic threshold for diabetes.

To investigate, Dr. Russell E. Anderson from Karolinska University Hospital in Stockholm and colleagues took a look back at 1815 patients who underwent CABG during 2001-2003 and who were classified preoperatively as having normal fasting blood glucose (n = 1070), impaired fasting blood glucose (n = 152), suspected diabetes mellitus (n = 153), or clinical diabetes (n = 440).

During follow up, 41 patients died within one month of CABG and 71 within one year of the surgery.

Compared with subjects with normal preoperative fasting blood glucose levels, those with impaired fasting blood glucose had a relative risk of 30-day and 1-year mortality of 1.7 and 2.9, respectively.

For individuals with suspected diabetes, the corresponding relative risks were 2.8 and 1.9, respectively, while the relative risks were 1.8 and 1.6 for individuals with clinical diabetes.

"The most conclusive findings of this study are that diabetes mellitus was associated with increased early mortality compared with patients with normal fasting blood glucose and with a tendency towards increased mortality within 1 year among survivors of 30 days," the authors write.

"More important, however, is that similar results were obtained for patients with impaired fasting glucose, although based on small numbers." Multivariate analysis did not markedly alter the findings.

The reasons why impaired fasting glucose may raise the risk of death early after CABG remain unclear, Dr. Anderson and colleagues say, "as is the question of whether pharmacological normalization of glucose homeostasis would normalize post-operative risk."

Euro Heart J 2005;26:1513-1518.

===========================

Help us keep this newsletter free—update your profile!!!!!!!!!!!!!!!!!!!!!!
https://www.diabetesincontrol.com/surveys/index.php