Prognosis Varies Per Glycemic Index Pre-Revascularization

Type 2 diabetes patients with HbA1c of 6 to 7 percent have lowest risk of adverse cardio events
By Monica Smith
HealthDay Reporter

WEDNESDAY, May 5 (HealthDay News) -- Having a low -- but not too low -- glycemic index prior to surgery is optimal for best cardiovascular outcomes after coronary revascularization in patients with type 2 diabetes mellitus (DM), according to a study in the April 1 issue of the American Journal of Cardiology.

To evaluate what effect glycemic level has on cardiovascular outcomes following a first elective coronary revascularization, Natsuhiko Ehara, M.D., of the Kobe City Medical Center General Hospital in Japan, and colleagues compared the hemoglobin A1c (HbA1c) status of 1,504 patients with type 2 DM taking hypoglycemic agents.

The researchers found that 202 patients had a very low HbA1c level (less than 6 percent), 426 had a low HbA1c level (at least 6 but less than 7 percent), 405 had an intermediate HbA1c level (at least 7 but less than 8 percent), and 471 had a high HbA1c level (at least 8 percent). In multivariate analyses, those in the low HbA1c group had the lowest hazard ratio for major adverse cardiovascular events (MACE) compared with those without DM (hazard ratio, 1.13). In a multivariate analysis using the low group as a reference, patients with high HbA1c had a significantly greater risk of MACE, and patients with very low and intermediate HbA1c tended to be linked to increased risk for MACE.

"In conclusion, patients with type 2 DM treated with hypoglycemic agents and undergoing first elective coronary revascularization had significantly worse cardiovascular outcomes than patients without DM, except for patients with DM and a HbA1c of 6 to 7 percent. In the patients with DM, those with a HbA1c of 6 to 7 percent tended to have the lowest risk of MACE," the authors write.

Full Text (subscription or payment may be required)

Copyright © 2010 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Debunking Three Rape Myths
Journal of Forensic Nursing, October/December 2014
Expires: 12/31/2016 CE:2.5 $24.95

Drug updates and approvals: 2014 in review
The Nurse Practitioner, 13December 2014
Expires: 12/31/2016 CE:3 $27.95

Can Food Processing Enhance Cancer Protection?
Nutrition Today, September/October 2014
Expires: 10/31/2016 CE:2 $21.95

More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events