Admission plasma glucose: an independent risk factor in nondiabetic women after coronary artery bypass grafting.
OBJECTIVE
To investigate the relationship between admission plasma glucose and 30-day mortality after primary isolated coronary artery bypass grafting (CABG) in nondiabetic patients.


METHODS
All nondiabetic patients with admission plasma glucose measurement undergoing primary isolated CABG from 1993 to 1997 were included in this study.


RESULTS
In 878 consecutive patients (155 women), overall mortality was 3.4% (95% CI 2.3-4.8). The mortality rate in women (n = 11; 7.1%, 3.6-12.3) was higher than in men (n = 19; 2.6%, 1.6-4.1) (P = 0.01). There was a positive correlation between plasma glucose and 30-day mortality among women only (P = 0.0001). There was a higher mortality rate in the upper two glucose quartiles (11.7%, 5.5-21.0) compared with the lower two quartiles (2.6%, 3.0-8.9) in the female patients (P = 0.03); a plasma glucose of 6.0 mmol/l separated high- and low-mortality groups. Furthermore, women in the upper two glucose quartiles had a fourfold higher mortality rate than men in the similar quartiles (P = 0.002). Among men, there was no difference in mortality rate across glucose quartiles. In a multivariate analysis, admission plasma glucose, history of thyroid disease, left ventricular ejection fraction <0.35, operation bypass time, and perioperative myocardial infarction were independently associated with mortality.


CONCLUSIONS
Women with admission plasma glucose < or =6.0 mmol/l and men across the whole range of glucose values had similar mortality rates after CABG. The surplus female mortality was found only in subjects with plasma glucose >6 mmol/l. Further studies are needed to appraise the possible influence of glucose status on outcome from CABG in nondiabetic subjects.
Zindrou
D
D
National Heart and Lung Institute, Imperial College School of Medicine, Cardiothoracic Directorate, Hammersmith Hospital, DuCane Road, London W12 0NN, U.K.
Taylor
K M
KM
Bagger
J P
JP
D000704:Analysis of Variance; D000787:Angina Pectoris / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000401:mortality*; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D012770:Shock, Cardiogenic / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose