ArticleThe Journal of thoracic and cardiovascular surgery2011
Superiority of moderate control of hyperglycemia to tight control in patients undergoing coronary artery bypass grafting.
Article in The Journal of thoracic and cardiovascular surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04451655 (Glycemic Stability During the Intraoperative Period Among Patients With DM Undergoing CABG Surgery), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Glycemic Stability During the Intraoperative Period Among Patients With DM Undergoing CABG Surgery
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2020Pooled it
- Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2020Pooled it
- Intensive Versus Conventional Glycemic Control in Patients with Diabetes During Enteral Nutrition After Gastrectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Trial
- Moderate glucose control results in less negative nitrogen balances in medical intensive care unit patients: a randomized, controlled study.Critical care (London, England) · 2012Trial
- Differential metabolomic signatures in plasma and urine under mild and moderate hypothermia during cardiopulmonary bypass.Scientific reports · 2025Article
- Perioperative glycemic control in patients undergoing cardiac surgery.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025Review
- Effect of glycemic control and glucose fluctuation on in-hospital adverse outcomes after on-pump coronary artery bypass grafting in patients with diabetes: a retrospective study.Diabetology & metabolic syndrome · 2023Article
- Strategies for post-cardiac surgery acute kidney injury prevention: A network meta-analysis of randomized controlled trials.Frontiers in cardiovascular medicine · 2022Article
- Association of intraoperative hyperglycemia with postoperative composite infection after cardiac surgery with cardiopulmonary bypass: A retrospective cohort study.Frontiers in cardiovascular medicine · 2022Article
- Article
- Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (Journal of clinical medicine · 2021Review
- Article
- Review
- Cardiac and Vascular Surgery-Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group.Journal of the American Heart Association · 2018Review
- Effect of glycaemic control on complications following cardiac surgery: literature review.Journal of cardiothoracic surgery · 2018Review
- Hyperglycemia and Acute Kidney Injury During the Perioperative Period.Current diabetes reports · 2016Review
- Blood glucose concentration for predicting poor outcomes in patients with and without impaired glucose metabolism undergoing off-pump coronary artery bypass surgery - long-term observational study.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2016Article
- Anesthesia Preoperative Clinic Referral for Elevated Hba1c Reduces Complication Rate in Diabetic Patients Undergoing Total Joint Arthroplasty.Anesthesiology and pain medicine · 2015Article
- Risk factors for perioperative hyperglycemia in primary hip and knee replacements.Acta orthopaedica · 2015Observational
- AKI associated with cardiac surgery.Clinical journal of the American Society of Nephrology : CJASN · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveAlthough consensus in cardiac surgery supports tight control of perioperative hyperglycemia (glucose<120 mg/dL), recent studies in critical care suggest moderate glycemic control may be superior. We sought to determine whether tight control or moderate glycemic control is optimal after coronary artery bypass grafting.
methodsFrom 1995 to 2008, a total of 4658 patients with known diabetes or perioperative hyperglycemia (preoperative glycosylated hemoglobin≥8 or postoperative serum glucose>126 mg/dL) underwent isolated coronary artery bypass grafting at our institution. Patients were stratified into 3 postoperative glycemic groups: tight (≤126 mg/dL), moderate (127-179 mg/dL), and liberal (≥180 mg/dL). Preoperative risk factors, glycemic management, and postoperative outcomes were analyzed.
resultsOperative mortality was 2.5% (119/4658); major complication rate was 12.5% (581/4658). Relative to moderate group, more patients in tight group had preoperative renal failure (tight 16.4%, 22/134, moderate 8.3%, 232/2785, P=.001) and underwent emergent operations (tight 5.2%, 7/134, moderate 1.9%, 52/2785, P=.007); however, Society of Thoracic Surgeons predicted mortality risk was lower in tight group (P<.001). Moderate group had lowest mortality (tight 2.9%, 4/134, moderate 2.0%, 56/2785, liberal 3.4%, 59/1739, P=.02) and incidence of major complications (tight 19.4%, 26/134, moderate 11.1%, 308/2785, liberate 14.2%, 247/1739, P<.001). Risk-adjusted major complication incidence (adjusted odds ratio 0.7, 95% confidence interval 0.58-0.87) and mortality (adjusted odds ratio 0.6, 95% confidence interval 0.37-0.83) were lower with moderate glucose control than with tight or liberal management.
conclusionsModerate glycemic control was superior to tight glycemic control, with decreased mortality and major complications, and may be ideal for patients undergoing isolated coronary artery bypass grafting.
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