The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 1 , Pages 29-37 , July 2007

Strict glycemic control reduces EuroSCORE expected mortality in diabetic patients undergoing myocardial revascularization

  • Cosimo D’Alessandro, MD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
    • Corresponding Author InformationAddress for reprints: Cosimo D’Alessandro, MD, Division of Thoracic and Cardiovascular Surgery, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75 651 Paris Cedex 13, France.
  • ,
  • Pascal Leprince, MD, PhD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
  • ,
  • Jean Louis Golmard, PhD

      Affiliations

    • Department of Biostatistics, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France.
  • ,
  • Alexandre Ouattara, MD, PhD

      Affiliations

    • Department of Anesthesia and Critical Care, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
  • ,
  • Stéphane Aubert, MD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
  • ,
  • Alain Pavie, MD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
  • ,
  • Iradj Gandjbakhch, MD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France
  • ,
  • Nicolas Bonnet, MD

      Affiliations

    • Institute of Cardiology, Division of Thoracic and Cardiovascular Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie-Paris, Paris, France

Received 27 July 2006 ,Revised 7 February 2007 ,Accepted 19 February 2007.

References 

  1. Bonow RO, Gheorghiade M. The diabetes epidemic: a national and global crisis. Am J Med. 2004;116(suppl 5A):2S–10S
  2. Kannel WB, McGee DL. Diabetes and cardiovascular risk: the Framingham study. JAMA. 1979;241:2035–2038
  3. Flaherty JD, Davidson JC. Diabetes and coronary revascularization. JAMA. 2005;293:1501–1508
  4. Edwards FH, Grower FL, Shroyer AL, Schwartz M, Bero J. The Society of Thoracic Surgeons National Cardiac Surgery Database: current risk assessment. Ann Thorac Surg. 1997;63:903–908
  5. Calafiore AM, Di Mauro M, Di Giammarco G, Contini M, Vitolla G, Iaco AL, et al. Effect of diabetes on early and late survival after isolated first coronary bypass surgery in multivessel disease. J Thorac Cardiovasc Surg. 2003;125:144–154
  6. Thourani VH, Weintraub WS, Stein B, Gebhart SSP, Craver MJ, Jones EL, et al. Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting. Ann Thorac Surg. 1999;67:1045–1052
  7. Barsness GW, Peterson ED, Ohmam EM, Nelson CL, DeLong ER, Reves JG, et al. Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty. Circulation. 1997;96:2551–2556
  8. Malmberg K, Ryden L, Hamsten A, Efendic S, Herlitz J, Nicol P, et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57–65
  9. Furnary AP, Gao G, Grunkemeier GL, Wu Y, Zerr KJ, Bookin SO, et al. Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003;125:1007–1021
  10. Lazar HL, Chipkin SR, Fitzgerald CA, Bao Y, Cabtal H, Apstein CS. Tight glycemic control in diabetic coronary bypass graft patients improves perioperative outcomes and decreases recurrent ischemic event. Circulation. 2004;109:1497–1502
  11. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359–1367
  12. Ouattara A, Lecomte P, Le Manach Y, Landi M, Jacqueminet S, Platonov I, et al. Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology. 2005;103:687–694
  13. Nashef SAM, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R, et al. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999;16:9–13
  14. D’Agostino RB. Tutorial in biostatistics: propensity score methods for bas reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17:2265–2281
  15. Blackstone EH. Comparing apples and oranges. J Thorac Cardiovasc Surg. 2002;123:8–15
  16. Furnary AP, Zerr KJ, Grunkemeier GL, Heller CA. Hyperglycemia: a predictor of mortality following CABG in diabetics. Circulation. 1999;100(suppl):I591
  17. Doenst T, Wijeysundera D, Karkouti K, Zechner C, Maganti M, Rao V, et al. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2005;130:1144–1150
  18. Chaney MA, Nikolov MP, Blakerman BP, Bakhos M. Attempting to maintain normoglycemia during cardiopulmonary bypass with insulin may initiate postoperative hypoglycemia. Anesth Analg. 1999;99:1091–1095
  19. Carvalho G, Moore A, Qizilbash B, Lachapelle K, Schricker T. Maintenance of normoglycemia during open cardiac surgery. Anesth Analg. 2004;99:319–324
  20. Schricker T, Carvalho G. Pro: tight perioperative glycemic control. J Cardiothorac Vasc Anesth. 2005;19:684–688
  21. Gogbashian A, Sedrakyan A, Treasure T. EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg. 2004;25:695–700
  22. Nilsson J, Algotsson L, Höglund P, Lührs C, Brandt J. Early mortality in coronary bypass surgery: the EuroSCORE versus The Society of Thoracic Surgeons risk algorithm. Ann Thorac Surg. 2004;77:1235–1239
  23. Toumpoulis IK, Anagnostopoulos CE, Toupoulis SK, DeRose JJ, Swistel DG. EuroSCORE predicts long-term mortality after valve surgery. Ann Thorac Surg. 2005;79:1902–1908
  24. Roques F, Michel P, Goldstone AR, Nashef SA. The logistic EuroSCORE. Eur Heart J. 2003;24:881–882
  25. Michel P, Roques F, Nashef SA The EuroSCORE Project Group. Logistic or additive EuroSCORE for high-risk patients?. Eur J Cardiothorac Surg. 2003;23:684–687
  26. Shanmungam G, West M, Berg G. Additive and logistic EuroSCORE performance in high risk patients. Interact Cardio Vasc Thorac Surg. 2005;28:240–243
  27. Jin R, Grunkemeier GL. Does the logistic EuroSCORE offer an advantage over the additive model?. Interact Cardio Vasc Thorac Surg. 2006;5:15–17
  28. Peterson ED, Delong ER, Muhlbaier LH, Rosen AB, Buell HE, Kiefe CI, et al. Challenges in comparing risk-adjusted bypass surgery mortality results: results from the Cooperative Cardiovascular Project. J Am Coll Cardiol. 2000;36:2174–2184
  29. Lytle BW, Blackstone EH, Loop FD, Houghtaling PL, Arnold JH, Akhrass R, et al. Two internal thoracic artery are better than one. J Thorac Cardiovasc Surg. 1999;117:855–872
  30. Peterson MD, Borger MA, Rao V, Peniston CM, Feindel CM. Skeletonization of bilateral internal thoracic artery grafts lowers the risk of sternal infection in patients with diabetes. J Thorac Cardiovasc Surg. 2003;1236:1314–1319
  31. Zerr KJ, Furnary AP, Grunkemeier Gl, Bookin S, Kanhere V, Starr A. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–361
  32. Furnary AP, Zerr KJ, Grunkemeier GL, Starr A. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999;67:352–360
  33. Borger MA, Rao V, Weisel RD, Ivanov J, Cohen G, Scully HE, et al. Deep sternal wound infection: risk factors and outcomes. Ann Thorac Surg. 1998;65:1050–1056
  34. Wilson SR, Vakili BA, Sherman W, Sanborn TA, Brown DL. Effect of diabetes on long-term mortality following contemporary percutaneous coronary intervention. Diabetes Care. 2004;27:1137–1142

PII: S0022-5223(07)00516-8

doi: 10.1016/j.jtcvs.2007.02.028

The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 1 , Pages 29-37 , July 2007