TITLE

Does microalbuminuria in diabetic patients affect the postoperative course after coronary artery bypass surgery?

AUTHOR(S)
Yorgancioglu, Cem; Tokmakoglu, Hilmi; Suzer, Kaya; Zorlutuna, Yaman
PUB. DATE
March 2002
SOURCE
European Journal of Cardio-Thoracic Surgery;Mar2002, Vol. 21 Issue 3, p395
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: Microalbuminuria is a predictor of microvascular disease and a marker for multiorgan damage in diabetic patients. It has been proposed that in diabetic patients who would undergo coronary artery bypass surgery (CABG), microalbuminuria is associated with poor postoperative outcome, higher incidence of early and late morbidity and mortality. Methods: Microalbuminuria was prospectively studied preoperatively in 24-h urinary collections for 257 consecutive diabetic patients in a 2-year period. One hundred and sixty-eight patients (65.4%) were defined as microalbuminuria negative (Group A), and 89 (34.6%) were microalbuminuria positive (Group B) with respect to the cut-off point 30 mg/24 h. Results: The two groups did not differ with respect to preoperative and operative data, except that preoperative blood glucose levels (P=0.046), blood urea nitrogen (P=0.001), and creatinine (P=0.001) were higher and creatinine clearance was lower (P=0.025) in Group B. Postoperative serum creatinine levels on different days were higher in microalbuminuria positive patients (P=0.04). Also, positive inotropic agent usages at the time of leaving the operating room (21.3 vs. 10.1%; P=0.013) and on the 1st day in the intensive care unit (ICU; 29.2 vs. 14.9%; P=0.014), ICU stay day (2.3±2 vs. 2.4±1.6; P=0.02) and also atrial fibrillation rate (30.3 vs. 17.9%) were higher in Group B (P=0.019). Total hospital stay (7.5±2.9 vs. 7.2±1.3) was similar. The 30-day mortality was 5.6 times higher (3.4 vs. 0.6%) but statistically not significant (P=0.088) in Group B. The mean follow-up was 30.6±16. 2 months in total (30.9±16.2 in Group A and 30.1±16.5 in Group B). There were 12 late deaths, nine were cardiac, and no differences were detected between groups. Conclusions: Our findings suggest that postoperative period may be more problematic in diabetic patients with microalbuminuria, but microalbuminuria does not seem to have a major effect on the postoperative course in patients undergoing CABG.
ACCESSION #
7766938

 

Related Articles

  • Bypasses to Tibial Vessels Using Polytetrafluoroethylene as the Solo Conduit in a Predominantly Diabetic Population. Hamdan, Allen D.; Ryan, Sunil S.; Hook, Shannon C.; Campbell, David R.; Akbari, Cameron M.; LoGerfo, Frank W.; Pomposelli, Frank B. // Vascular & Endovascular Surgery;Jan/Feb2002, Vol. 36 Issue 1, p59 

    Examines the results of bypasses to tibial vessels using polytetrafluoroethylene (PTFE) as solo conduit in a diabetic population in Boston, Massachusetts. Configurations of PTFE grafts by inflow and outflow vessels; Summary on outcomes of graft patency, limb salvage and patient survival; Effect...

  • A new warning for heart patients with diabetes.  // Countdown;Winter96, Vol. 17 Issue 1, p12 

    Reports that for patients with diabetes, angioplasty procedures to clear heart blockages can have significantly greater risks than bypass surgery. Clinical alert issued by the National Heart, Lung and Blood Institute to physicians recommending coronary bypass surgery as the preferred treatment...

  • Diabetes and Coronary Artery Bypass Surgery. McAlister, Finlay A.; Man, Jeremy; Bistritz, Lana; Amad, Hani; Tandon, Puneeta // Diabetes Care;May2003, Vol. 26 Issue 5, p1518 

    OBJECTIVE — To determine the adequacy of perioperative glycemic control in diabetic patients undergoing coronary artery bypass grafting (CABG) and to explore the association between glycemic control and in-hospital morbidity/mortality. RESEARCH DESIGN AND METHODS — Retrospective...

  • Influence of Type 2 Diabetes on Functional and Structural Properties of Coronary Artery Bypass Conduits. Lorusso, Roberto; Pentiricci, Samuele; Raddino, Riccardo; Scarabelli, Tiziano M.; Zambelli, Claudia; Villanacci, Vincenzo; Burattin, Anna; Romanelli, Giuseppe; Giustina, Andrea; Casari, Salvatore; Scelsi, Roberto // Diabetes;Nov2003, Vol. 52 Issue 11, p2814 

    Recent studies have reported a high incidence of postoperative unfavorable cardiac-related events in patients with diabetes who underwent coronary artery bypass grafting (CABG). Structural and functional characteristics of CABG conduits, which have been shown to play an important role in patient...

  • CARDIOLOGY TODAY Editorial Board ranks top news in cardiology from 2012.  // Cardiology Today;Jan2013, Vol. 16 Issue 1, p1 

    A list of the top 10 articles published in the journal "Cardiology Today" in 2012 is presented including "Results of the FREEDOM Trial: CABG Bested PCI for Patients With Diabetes and Multivessel Disease," "The Promise of Renal Denervation for Resistant Hypertension," and "New Research Into...

  • Absent improvement after angioplasty. P.F.C. // Cortlandt Forum;08/25/97, Vol. 10 Issue 8, p66 

    Reports that coronary artery bypass grafting (CBGA) is a better treatment procedure for diabetics compared to percutaneous transluminal coronary angioplasty (PTCA). Percentage of people who underwent angioplasty procedures that require for a second or third angioplasty procedure.

  • Bypass grafts protect diabetic patients better than angioplasty. Gottlieb, Scott // BMJ: British Medical Journal (International Edition);04/15/2000, Vol. 320 Issue 7241, p1029 

    Provides information on a second report which stated that people with diabetes who have coronary artery disease fare better after bypass surgery than after balloon angioplasty. Survival rates of diabetic patients who had undergone angioplasty and bypass surgery; Details on the report.

  • CABG or angioplasty in patients with diabetes? Pinkowish, Mary Desmond // Patient Care;2/15/1998, Vol. 32 Issue 3, p157 

    Presents a study which compares the use of coronary artery bypass graft (CABG) surgery to percutaneous transluminal coronary angioplasty (PTCA) for revascularization in diabetic patients. Reference to a 1995 clinical alert from the National Heart, Lung, and Blood Institute; Views from...

  • Renewal: ongoing process in BJCVS. Braile, Domingo M. // Brazilian Journal of Cardiovascular Surgery;oct-dec2012, Vol. 27 Issue 4, preceding p503 

    An introduction is presented in which the editor discusses various reports within the issue on topics including the impact of risk scores in coronary artery bypass surgery, an investigation into the link between diabetes mellitus and immediate surgical risk in octogenarian patients who underwent...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics