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Diabetes and Vascular Disease Research
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Only a minority of patients referred for elective coronary artery bypass surgery have risk factors diagnosed and treated according to established guidelines

Russell E Anderson

Section for Cardiothoracic Surgery and Anaesthesiology, Department of Molecular Medicine and Surgery, Karolinska Institute, S-171 76, Stockholm, Sweden.

Kerstin Brismar

Unit of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institute, S-171 76, Stockholm, Sweden.

Torbjörn Ivert

Section for Cardiothoracic Surgery and Anaesthesiology, Department of Molecular Medicine and Surgery, Karolinska Institute, S-171 76, Stockholm, Sweden.

Patients deserve to be medically optimised for treatment of metabolic risk factors and hypertension before referral for elective coronary artery bypass grafting (CABG). We describe here a prospective study of 347 consecutive patients referred for elective CABG. An oral glucose tolerance test (OGTT) was performed and metabolic risk factors and hypertension were determined pre-operatively. Compliance to treatment guidelines was calculated.

From the total of 347 patients, 80 patients (23%) had known and 66 (19%) had previously unknown diabetes. Dysglycaemia (that is, diabetes and pre-diabetes) was found in 194 (73%) of the 267 patients without known diabetes. Among patients with dysglycaemia, 111/274 (41%) received one antihypertensive medication, or none, and blood pressure guidelines were met in 39/274 (14%); statins were being taken by 206 (75%; average dose 23 mg simvastatin) and low-density lipoprotein (LDL)-cholesterol guidelines were met in 43 (16%).

In conclusion, diabetes diagnosis and titration of risk factor treatment to guidelines is inadequate even in elective CABG patients. A pre-admission OGTT affords an opportunity to improve care significantly.

Key Words: diabetes mellitus • OGTT • coronary artery bypass grafting • risk factors

Diabetes and Vascular Disease Research, Vol. 4, No. 2, 112-116 (2007)
DOI: 10.3132/dvdr.2007.028
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