Association between stress hyperglycaemia and in‐hospital cardiac events after coronary artery bypass grafting in patients without diabetes: A retrospective observational study of 5450 patients

Author:

Li Xiaojue1,Hou Xiaopei12,Zhang Heng3,Qian Xin1ORCID,Feng Xinxing1,Shi Na1,Guo Rong1,Sun Hansong3,Feng Wei3,Zhao Wei4,Li Guangwei1ORCID,Zheng Zhe3,Chen Yanyan15ORCID

Affiliation:

1. Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

2. Department of Geriatrics Beijing Friendship Hospital, Capital Medical University Beijing China

3. Department of Cardiovascular Surgery Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences Beijing China

4. Information Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences Beijing China

5. Department of Endocrinology Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen China

Abstract

AbstractAimsTo investigate the impact of stress hyperglycaemia (SH) on in‐hospital adverse cardiac events after coronary artery bypass grafting (CABG) in patients without diabetes.Materials and MethodsIn total, 5450 patients without diabetes who underwent CABG were analysed. SH was defined as any two instances in which the random blood glucose level was >7.8 mmol/L after CABG in the intensive care unit (ICU). The primary outcome was major adverse cardiac events (MACEs), including in‐hospital mortality, acute myocardial infarction, stroke and acute renal failure. Secondary outcomes included surgical site infection (SSI) and length of ICU stay.ResultsPatients with SH had higher rates of MACEs (5.7% vs. 2.3%, p < .0001) and higher SSI (3.3% vs. 1.4%, p = .0003) and longer ICU stays (2.6 ± 2.0 vs. 1.3 ± 1.3 days, p < .0001) than those without SH. Furthermore, SH was associated with a higher risk of MACEs [odds ratio (OR): 2.32, 95% confidence interval (CI): 1.38‐3.90], SSI (OR: 2.21, 95% CI: 1.20‐3.95) and longer ICU stay (OR: 12.27, 95% CI: 9.41‐16.92) after adjusting for confounders. Subgroup analysis showed that patients with SH >10 mmol/L or SH that occurred in the ICU and lasted more than 48 h had increased risks of postoperative complications (p < .05).ConclusionsSH was significantly associated with an increased risk of MACEs, SSI and longer ICU stay after CABG in patients without diabetes. In addition, SH >10 mmol/L or that occurred in the ICU and lasted more than 48 h increased the risk of adverse outcomes.

Publisher

Wiley

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine

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