title: Diabetic control and coronary artery bypass: effect on short-term outcomes.
abstract: OBJECTIVE
  To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting.
  
  
  METHODS
  Data of 3857 patients undergoing primary coronary artery bypass grafting was prospectively collected and retrospectively analyzed. There were 1109 (29%) diabetic patients, of whom 712 (64%) had hemoglobin A1c levels recorded. They were categorized by diabetic treatment: diet (179), oral hypoglycemic agent, (718) or insulin (212); and by diabetic control: hemoglobin A1c < 7 (265) or ≥7 (447). Nondiabetic patients (2,748) were used as controls.
  
  
  RESULTS
  The preoperative risk factors of hypertension (p < 0.001), hyperlipidemia (p < 0.001), renal failure (p < 0.04), peripheral vascular disease (p < 0.001), and chronic obstructive pulmonary disease (p < 0.04) were significantly more prevalent in diabetic patients. Major complications were not significantly different between the diabetic and control groups (p = 0.33), but minor complications were less frequent in diabetic patients (p = 0.03). Major and minor complications were not significantly different among the treatment subgroups of diabetic patients (p = 0.74 and p = 0.48) or in those with hemoglobin A1c < 7 and ≥7 (p = 0.23, p = 0.41).
  
  
  CONCLUSIONS
  Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.
authors.affiliation: Department of Cardiac Surgery, Princesses Alexandria Hospital, Brisbane, Queensland, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Strahan
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Harvey
authors.forename: Andrew
authors.initials: A
authors.lastname: Campbell-Lloyd
authors.forename: Elaine
authors.initials: E
authors.lastname: Beller
authors.forename: Julie
authors.initials: J
authors.lastname: Mundy
authors.forename: Pallav
authors.initials: P
authors.lastname: Shah
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006442:Glycated Hemoglobin / Q000378:metabolism; D017052:Hospital Mortality; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Blood glucose; coronary artery bypass; diabetes mellitus; postoperative complications; treatment outcome