Impaired glucose regulation, elevated glycated haemoglobin and cardiac ischaemic events in vascular surgery patients

Diabetic Medicine : a Journal of the British Diabetic Association
Harm H H FeringaDon Poldermans

Abstract

Cardiac morbidity and mortality is high in patients undergoing high-risk surgery. This study investigated whether impaired glucose regulation and elevated glycated haemoglobin (HbA(1c)) levels are associated with increased cardiac ischaemic events in vascular surgery patients. Baseline glucose and HbA(1c) were measured in 401 vascular surgery patients. Glucose < 5.6 mmol/l was defined as normal. Fasting glucose 5.6-7.0 mmol/l or random glucose 5.6-11.1 mmol/l was defined as impaired glucose regulation. Fasting glucose > or = 7.0 or random glucose > or = 11.1 mmol/l was defined as diabetes. Perioperative ischaemia was identified by 72-h Holter monitoring. Troponin T was measured on days 1, 3 and 7 and before discharge. Cardiac death or Q-wave myocardial infarction was noted at 30-day and longer-term follow-up (mean 2.5 years). Mean (+/- sd) level for glucose was 6.3 +/- 2.3 mmol/l and for HbA(1c) 6.2 +/- 1.3%. Ischaemia, troponin release, 30-day and long-term cardiac events occurred in 27, 22, 6 and 17%, respectively. Using subjects with normal glucose levels as the reference category, multivariate analysis revealed that patients with impaired glucose regulation and diabetes were at 2.2- and 2.6-fold increased risk of ischaemia,...Continue Reading

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Citations

Oct 7, 2011·World Journal of Surgery·Takehiro OkabayashiKazuhiro Hanazaki
Dec 25, 2015·Current Diabetes Reports·Bithika M ThompsonCurtiss B Cook
Jun 15, 2010·Nutrition·Roupen HatzakorzianThomas Schricker
Jun 13, 2009·Best Practice & Research. Clinical Endocrinology & Metabolism·Sanne HoeksDon Poldermans
Jul 18, 2009·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·J P van KuijkD Poldermans
Jul 12, 2016·Best Practice & Research. Clinical Anaesthesiology·O BoehmA Hoeft
Mar 2, 2016·Anesthesiology Clinics·Matthias BockDavid L Hepner
Feb 10, 2011·Journal of Diabetes Science and Technology·David C Klonoff
Feb 11, 2010·Journal of Diabetes Science and Technology·Ann M Sheehy, Robert A Gabbay
Jun 21, 2015·Journal of Diabetes Science and Technology·Patricia A MackeyCurtiss B Cook
Dec 17, 2009·Foot & Ankle International·Alastair Se YoungerGwyneth de Vries
Oct 13, 2009·International Anesthesiology Clinics·Sona SharmaMercedes Falciglia
Jun 17, 2018·Current Diabetes Reports·Estelle Everett, Nestoras Mathioudakis
Aug 6, 2013·Journal of Diabetes Science and Technology·Kathryn E CoanCurtiss B Cook
Nov 11, 2020·Mayo Clinic Proceedings·Carina P HimesMark Liebow
Sep 15, 2021·World Neurosurgery·Tomoko TanakaN Scott Litofsky

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