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glycemic control in CABG

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https://www.readbyqxmd.com/read/27861432/the-association-between-preoperative-hemoglobin-a1c-and-postoperative-glycemic-variability-on-30-day-major-adverse-outcomes-following-isolated-cardiac-valvular-surgery
#1
Amit Bardia, Kamal Khabbaz, Ariel Mueller, Priyam Mathur, Victor Novack, Daniel Talmor, Balachundhar Subramaniam
BACKGROUND: Preoperative hemoglobin A1c (HbA1c) and postoperative glycemic variability predict major adverse events (MAEs) after coronary artery bypass grafting in a protocolized glycemic control setting. However, the influence of preoperative HbA1c and postoperative glycemic variability in isolated cardiac valvular surgery is unknown. In this study, we sought to establish (a) whether preoperative HbA1c could identify patients at increased risk of MAEs and (b) whether postoperative glycemic variability was associated with MAEs after isolated cardiac valvular surgery...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26962814/comparing-the-clinical-outcomes-between-insulin-treated-and-non-insulin-treated-patients-with-type-2-diabetes-mellitus-after-coronary-artery-bypass-surgery-a-systematic-review-and-meta-analysis
#2
REVIEW
Krishna Munnee, Pravesh K Bundhun, Hongzhi Quan, Zhangui Tang
Several studies have shown coronary artery bypass surgery (CABG) to be beneficial in patients with type 2 diabetes mellitus (T2DM) and multivessel coronary artery diseases. Patients with insulin-treated T2DM (ITDM) are usually patients with poor glycemic control and are expected to suffer more complications compared with patients with non-insulin-treated T2DM (NITDM). However, the adverse clinical outcomes in patients with ITDM and NITDM after CABG are still not very clear. Hence, to solve this issue, we aim to compare the short-and long-term adverse clinical outcomes in a larger number of patients with ITDM and NITDM after CABG, respectively...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26227192/glycemic-control-in-type-1-diabetes-and-long-term-risk-of-cardiovascular-events-or-death-after-coronary-artery-bypass-grafting
#3
Thomas Nyström, Martin J Holzmann, Björn Eliasson, Jeanette Kuhl, Ulrik Sartipy
BACKGROUND: Patients with type 1 diabetes mellitus (T1DM) have a high risk of cardiovascular events. OBJECTIVES: The aim of this study was to investigate whether preoperative hemoglobin A1c (HbA1c) levels could predict cardiovascular events or death after coronary artery bypass grafting (CABG). METHODS: This was a nationwide population-based observational cohort study that included all patients with T1DM who underwent primary isolated nonemergency CABG in Sweden between 1997 and 2012, according to the Swedish National Diabetes Register and the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) register...
August 4, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26180108/randomized-controlled-trial-of-intensive-versus-conservative-glucose-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-gluco-cabg-trial
#4
RANDOMIZED CONTROLLED TRIAL
Guillermo Umpierrez, Saumeth Cardona, Francisco Pasquel, Sol Jacobs, Limin Peng, Michael Unigwe, Christopher A Newton, Dawn Smiley-Byrd, Priyathama Vellanki, Michael Halkos, John D Puskas, Robert A Guyton, Vinod H Thourani
OBJECTIVE: The optimal level of glycemic control needed to improve outcomes in cardiac surgery patients remains controversial. RESEARCH DESIGN AND METHODS: We randomized patients with diabetes (n = 152) and without diabetes (n = 150) with hyperglycemia to an intensive glucose target of 100-140 mg/dL (n = 151) or to a conservative target of 141-180 mg/dL (n = 151) after coronary artery bypass surgery (CABG) surgery. After the intensive care unit (ICU), patients received a single treatment regimen in the hospital and 90 days postdischarge...
September 2015: Diabetes Care
https://www.readbyqxmd.com/read/25478539/effects-of-moderate-glycemic-control-in-type-ii-diabetes-with-insulin-on-arterial-blood-gas-parameters-following-coronary-artery-bypass-graft-surgery
#5
Gholamreza Masoumi, Rasoul Frasatkhish, Alireza Jalali, Mohsen Ziyaeifard, Ali Sadeghpour-Tabae, Mojtaba Mansouri
BACKGROUND: Coronary artery bypass grafting (CABG) is one of the common surgeries in patients with coronary artery disease (CAD). It is more probable for patients with diabetes to undergo surgeries due to CAD and they have a higher mortality rate compared to the others. OBJECTIVES: The aim of the present study was to assess the effects of insulin infusion therapy on blood gas parameters in two groups of patients, eligible for CABG, defined as A: well controlled diabetes (HbA1C < 7%) and B: non-diabetic patients...
May 2014: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/25392072/postoperative-hyperglycemia-and-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery
#6
Wataru Tatsuishi, Hitoshi Adachi, Makoto Murata, Junichi Tomono, Shuichi Okonogi, Syuichi Okada, Yutaka Hasegawa, Masahiko Ezure, Tatsuo Kaneko, Shigeru Ohshima
BACKGROUND: Postoperative atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG). We investigated the risk factors for postoperative AF and analyzed the relationship between blood sugar concentration (BS) and AF after CABG. METHODS AND RESULTS: A total of 199 consecutive patients who underwent isolated CABG were retrospectively examined and classified according to the presence (n=95) or absence (n=104) of postoperative AF...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/25161684/glycemic-control-in-type-2-diabetes-mellitus-prevents-coronary-arterial-wall-infection
#7
Morteza Izadi, Mojgan Fazel, Reza Karbasi-Afshar, Seyed Hassan Saadat, Mohammad Hassan Nasseri, Nematollah Jonaidi-Jafari, Reza Ranjbar, Davood Kazemi-Saleh
BACKGROUND: Diabetes mellitus (DM) is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG), with especial focus on the inhabitation of infectious agents within the coronary arterial wall. METHODS: In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran) were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR) methods for detecting Helicobacter species, cytomegalovirus (CMV) and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients...
May 2014: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/24445629/increased-glycemic-variability-in-patients-with-elevated-preoperative-hba1c-predicts-adverse-outcomes-following-coronary-artery-bypass-grafting-surgery
#8
Balachundhar Subramaniam, Adam Lerner, Victor Novack, Kamal Khabbaz, Maya Paryente-Wiesmann, Philip Hess, Daniel Talmor
BACKGROUND: In the setting of protocolized glycemic control, the relationship between postoperative glycemic variability on major adverse events (MAEs) after cardiac surgery is unknown for patients with increased preoperative hemoglobin A1C (HbA1C >6.5%). In this study, we sought to establish (a) whether postoperative glycemic variability is associated with MAEs after CABG surgery and (b) whether preoperative HbA1C could identify patients at increased risk of postoperative glycemic variability...
February 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24341049/glucosa-insulin-potassium-gik-solution-used-with-diabetic-patients-provides-better-recovery-after-coronary-bypass-operations
#9
RANDOMIZED CONTROLLED TRIAL
Slavenka Straus, Vjekoslav Gerc, Mirsad Kacila, Custovic Faruk
INTRODUCTION: Tight blood glucose control has become a therapeutical goal for anesthetic management for patients scheduled for cardiac surgery, especially if they are diabetic patients. AIM: This study was created to confirm the benefits of intraoperative GIK solution usage during coronary bypass operation of diabetic patients. METHODS: Patients with type 1 and 2 diabetes mellitus (DM) referred for coronary artery bypass grafting (CABG) were randomized to receive GIK solution (GIK--study group) in the first 24 hours intraoperatively or to receive official Clinical protocol without GIK solution (non GIK - control group)...
2013: Medical Archives
https://www.readbyqxmd.com/read/23807516/effects-of-glycemia-on-immediate-complications-following-cabg
#10
Glenn R Cunningham, Daoud Daoud, Susan Baimbridge, Charles Baimbridge, Shadi Abdelnour
OBJECTIVE: We investigated the relationship between postoperative glucose levels (days 1 through 3) and immediate outcomes in patients who underwent isolated coronary artery bypass grafting (CABG). METHODS: We conducted a retrospective study of 2,558 consecutive patients who had isolated CABG. Patients were stratified into 3 groups based on their pre-operative mortality risk (MR), using Society of Thoracic Surgeons' criteria. Average glucose levels for the first 3 days following surgery were determined...
November 2013: Endocrine Practice
https://www.readbyqxmd.com/read/23589926/comparison-of-the-effect-of-intensive-versus-conventional-insulinotherapy-in-patients-with-cardiac-surgery-after-cardiopulmonary-bypass
#11
COMPARATIVE STUDY
Huey-Ling Liou, Chun-Che Shih, Kwei-Chun Chung, Hsing I Chen
Hyperglycemia occurs commonly in clinically ill patients. Insulin therapy and glycemic control have been recommended for patients with septic shock. The present study investigated the effect of intensive (INIT) versus conventional insulinotherapy (COIT) in cardiac surgery patients who received cardiopulmonary bypass (CPB). In this quasi-experimental study, a total of 50 patients undergoing coronary artery bypass grafting (CABG) were recruited into the INIT and COIT groups. Study measures included serum glucose levels, cardiac output, cytokines, C-reactive protein (CRP), duration of mechanical ventilation and length of stay in the intensive care unit (ICU), and ICU mortality rate...
April 30, 2013: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/23439350/in-hospital-outcomes-of-pedicled-bilateral-internal-mammary-artery-use-in-diabetic-and-nondiabetic-patients-undergoing-off-pump-coronary-artery-bypass-grafting-single-surgeon-single-center-experience
#12
Shahzad G Raja, Kareem Salhiyyah, Muhammad Umar Rafiq, Manoraj Navaratnarajah, Dimple Chudasama, Christopher P Walker, Fouad Amin, Mohamed Amrani
OBJECTIVE: A common perception is that use of pedicled bilateral internal mammary arteries (BIMA) increases the risk of sternal wound complications in diabetic patients undergoing coronary artery bypass grafting (CABG). The purpose of this study was to compare the in-hospital outcomes of CABG using pedicled BIMA in diabetic and nondiabetic patients. METHODS: From September 1998 to September 2010, 390 consecutive diabetic patients and 519 nondiabetic patients underwent isolated off-pump CABG using pedicled BIMA...
February 1, 2013: Heart Surgery Forum
https://www.readbyqxmd.com/read/23323078/determinants-of-length-of-stay-in-surgical-ward-after-coronary-bypass-surgery-glycosylated-hemoglobin-as-a-predictor-in-all-patients-diabetic-or-non-diabetic
#13
Mahdi Najafi, Hamidreza Goodarzynejad
BACKGROUND: Reports on the determinants of morbidity in coronary artery bypass graft surgery (CABG) have focused on outcome measures such as length of postoperative stay in the Intensive Care Unit (ICU). We proposed that major comorbidities in the ICU hampered the prognostic effect of other weaker but important preventable risk factors with effect on patients' length of hospitalization. So we aimed at evaluating postoperative length of stay in the ICU and surgical ward separately. METHODS: We studied isolated CABG candidates who were not dialysis dependent...
November 2012: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/23209941/glycemic-control-during-coronary-artery-bypass-graft-surgery
#14
Harold L Lazar
Hyperglycemia, which occurs in the perioperative period during cardiac surgery, has been shown to be associated with increased morbidity and mortality. The management of perioperative hyperglycemia during coronary artery bypass graft surgery and all cardiac surgical procedures has been the focus of intensive study in recent years. This report will paper the pathophysiology responsible for the detrimental effects of perioperative hyperglycemia during cardiac surgery, show how continuous insulin infusions in the perioperative period have improved outcomes, and discuss the results of trials designed to determine what level of a glycemic control is necessary to achieve optimal clinical outcomes...
2012: ISRN Cardiology
https://www.readbyqxmd.com/read/22873042/how-important-is-glycemic-control-during-coronary-artery-bypass
#15
REVIEW
Harold L Lazar
In summary, poor perioperative glycemic control in patients undergoing CABG is associated with increased morbidity and mortality. Maintaining serum glucose less than or equal to 180 mg/dL in patients with diabetes during CABG reduces morbidity and mortality, lowers the incidence of wound infections, reduces hospital length of stay, and enhances long-term survival. In nondiabetic patients undergoing CABG surgery, maintaining serum glucose less than 180 mg/dL has also resulted in improved perioperative outcomes...
2012: Advances in Surgery
https://www.readbyqxmd.com/read/22761080/implementation-of-a-pharmacist-led-multidisciplinary-diabetes-management-team
#16
Laurie Warrington, Phil Ayers, Anna Marie Baldwin, Virginia Wallace, Krista D Riche, Robert Saulters, Oliver Grey Waldrop, Teri Dyess, Gordon Bart Delashmet, Samuel Peeples, W Stewart Horsley, William J Harris, Kenneth Butler
PURPOSE: The development, implementation, and evaluation of a pharmacist-led, multidisciplinary diabetes management team (DMT) at a 564-bed medical center in Jackson, Mississippi, are described. SUMMARY: The overwhelming prevalence of diabetes in Mississippi has a major impact on the state's health care system. Mississippi Baptist Health Systems (MBHS) developed a consultation-driven DMT in November 2008. The DMT embraced the multidisciplinary approach by uniting pharmacists, physicians, and other health care providers to optimize the care of patients with diabetes...
July 15, 2012: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/22729296/clinical-and-metabolic-results-of-fasting-abbreviation-with-carbohydrates-in-coronary-artery-bypass-graft-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Gibran Roder Feguri, Paulo Ruiz Lúcio Lima, Andréa Mazoni Lopes, Andréa Roledo, Miriam Marchese, Mônica Trevisan, Haitham Ahmad, Bruno Baranhuk de Freitas, José Eduardo de Aguilar-Nascimento
INTRODUCTION: Limited information is available about preoperative fasting abbreviation with administration of liquid enriched with carbohydrates (CHO) in cardiovascular surgeries. OBJECTIVES: To evaluate clinical variables, security of the method and effects on the metabolism of patients undergoing fasting abbreviation in coronary artery bypass graft (CABG) surgery. METHODS: Forty patients undergoing CABG were randomized to receive 400 ml (6 hours before) and 200 ml (2 hours before) of maltodextrin at 12...
January 2012: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/22650221/how-to-best-manage-glycemia-and-non-glycemia-during-the-time-of-acute-myocardial-infarction
#18
REVIEW
Irl B Hirsch, Kevin D O'Brien
Acute myocardial infarction (AMI) is common in patients with diabetes. Reasons for this are multifactorial, but all relate to a variety of maladaptive responses to acute hyperglycemia. Persistent hyperglycemia is associated with worse left ventricular function and higher mortality during AMI, but intervention data are far from clear. Although there is a theoretical basis for the use of glucose-insulin-potassium infusion during AMI, lack of outcome efficacy (and inability to reach glycemic targets) in recent randomized trials has resulted in little enthusiasm for this strategy...
June 2012: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/22640228/a-primer-for-achieving-glycemic-control-in-the-cardiac-surgical-patient
#19
REVIEW
Marie E McDonnell, Sara M Alexanian, Lynn White, Harold L Lazar
Maintaining glycemic control (blood glucose <180 mg/dL) has been shown to reduce morbidity and enhance long-term survival in patients with diabetes mellitus following coronary artery bypass graft (CABG) surgery. In this review we present a management strategy to achieve perioperative glycemic control in all patients undergoing CABG surgery, with and without diabetes mellitus, designed to achieve compliance with current Surgical Care Improvement Project (SCIP) and Society of Thoracic Surgeons (STS) guidelines...
July 2012: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/22590838/metformin-as-an-adjunct-to-insulin-for-glycemic-control-in-patients-with-type-2-diabetes-after-cabg-surgery-a-randomized-double-blind-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Afshin Gholipour Baradari, Amir Emami Zeydi, Mohsen Aarabi, Rahman Ghafari
Perioperative hyperglycemia is common in patients with type 2 diabetes undergoing Coronary Artery Bypass Graft (CABG) surgery and there is a direct relation between postoperative hyperglycemia and mortality rate in these patients. The aim of the present study is to determine the efficacy of metformin on glycemic control in diabetic patients after CABG surgery. In a randomized double blind clinical trial, 100 patients with type 2 diabetes admitted in open heart ICU after CABG surgery in Mazandaran Heart Center were enrolled...
December 1, 2011: Pakistan Journal of Biological Sciences: PJBS
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