Postoperative High Blood Glucose

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp the chronic effects of hyperglycemia, but the results are conflicting. In a survey of hospitalized patients, AF occurred in 14.9% of those with DM compared with 10.3% in the control group made up of patients with hypertension but not DM. 4 The Framingham Study identified DM as an independent risk factor for AF. 5 Iguchi et al reported that among 41,436 residents of a Japanese city, the prevalence of DM was higher in those with than without AF (20% vs. 12%) and the multivariate analysis reported that DM was independently associated with AF. 6 However, in the development of risk score for AF using the data from the Framingham cohort, DM was not a significant predictor. 7 Thus, the mechanisms that cause AF seem to be complex and likely reflect the interactions of multiple factors such as in metabolic syndrome, depending on the underlying pathology and other patient-related factors. 8 Moreover, some studies have questioned whether DM is a direct cause of AF while acknowledging the positive correlation between them. In the large cohort study of 34,720 females carried out by Schoen et al, there was a significant relationship between DM and the incidence of AF, but most of the increased risk attributed to trial fibrillation (AF) is one of the most common complications of coronary artery bypass grafting (CABG) and a major cause of concern because of its association with an increased risk of thromboembolic events. 1 In addition, AF can lead to hemodynamic compromise in response to the loss of effective atrial contraction during ventricular diastole and an irregular and abnormal ventricular filling time. Article p 112Patients recovering from major surgery, such as CABG, are affected by a unique set of factors that may contribute to AF and are clearly very different from the stress factors of daily life ( Figure). In a retrospective study of 199 consecutive CABG patients, Tatsuishi et al found a positive correlation between high postoperative blood sugar concentration (BS) and a higher incidence of post-CABG AF. 2 Diabetes mellitus (DM) is one of the most common concomitant diseases in patients with AF. 3 Many epidemiological studies have examined the risk of AF in relation to DM and AThe opinions expressed in this article are not necessarily those of the editors or of the Japanese Circulation Society.