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Influence of Diabetes on Cardiovascular Events

Diabetes Care; ePub 2018 Apr 4; Newman, et al

In a recent analysis of >10.5 million non-cardiac surgeries from a large US hospital admission database, perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) were more common among patients with diabetes mellitus (DM) vs without DM. Perioperative MACCEs increased over time and individual end points were all less favorable for patients with DM. Patients aged ≥45 years who underwent non-cardiac surgery from January 2004 to December 2013 were identified using the US National Inpatient Sample. Perioperative MACCEs (in-hospital all-cause mortality, acute myocardial infarction, or acute ischemic stroke) by DM status were evaluated over time. Researchers found:

  • The final study sample consisted of 10,581,621 hospitalizations for major non-cardiac surgery; DM was present in ∼23% of surgeries and increased over time.
  • Patients with DM experienced MACCEs in 3.3% of surgeries vs 2.8% of surgeries for patients without DM.
  • From 2004 to 2013, the odds of perioperative MACCEs after multivariable adjustment increased by 6% for DM patients, compared with an 8% decrease for patients without DM.
  • Trends for individual end points were all less favorable for patients with DM vs those without DM.

Citation:

Newman JD, Wilcox T, Smilowitz NR, Berger JS. Influence of diabetes on trends in perioperative cardiovascular events. [Published online ahead of print April 4, 2018]. Diabetes Care. doi:10.2337/dc17-2046.

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