Preoperative Assessment and Perioperative Management of the Surgical Patient With Diabetes Mellitus

  • Alanna Coolong
  • Mylan C. Cohen
Part of the Contemporary Cardiology book series (CONCARD)


Patients with diabetes mellitus (DM) are more likely than patients without diabetes to undergo surgery and may be at higher than average risk to suffer perioperative complications, usually because of frequent concomitant cardiovascular disease (CVD). The manifestations of CVD in patients with diabetes are often atypical, making identification and management more difficult (1,2). The role of the physician asked to provide preoperative consultation is to work with the surgical team in assessing and reducing the risk of complications in the perioperative period, and to identify opportunities to make a favorable impact on long-term health. In caring for the patient with diabetes perioperatively, heightened awareness of the higher incidence of coronary artery disease (CAD), silent ischemia, and increased predisposition to postoperative complications of infection, hyperglycemia, and hypoglycemia is necessary to permit the best outcomes to occur.


Noncardiac Surgery Abdominal Aortic Surgery Major Vascular Surgery Coronary Artery Surgery Study Peripheral Vascular Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alpert JS, Chipkin SR, Aronin N. Diabetes mellitus and silent myocardial ischemia. Adv Cardiol 1990;37:279–303.Google Scholar
  2. 2.
    Titus BG, Sherman CT. Asymptomatic myocardial ischemia during percutaneous transluminal coronary angioplasty and importance of prior Q-wave infarction and diabetes mellitus. Am J Cardiol 1991;68:735–739.PubMedCrossRefGoogle Scholar
  3. 3.
    Mangano DT. Perioperative cardiac morbidity. Anesthesiology 1990;72(1):153–184.PubMedCrossRefGoogle Scholar
  4. 4.
    National Center for Health Statistics. Available from Accessed July 17, 2003.
  5. 5.
    Massie BM, Mangano DT. Risk stratification for noncardiac surgery. How (and why)? [editorial; comment] [see comments]. Circulation 1993;87(5):1752–1755.PubMedGoogle Scholar
  6. 6.
    Rose SD, Corman LC, Mason DT. Cardiac risk factors in patients undergoing noncardiac surgery. Med Clin North Am 1979;63(6):1271–1288.PubMedGoogle Scholar
  7. 7.
    Ashton CM, Petersen NJ, Wray NP, et al. The incidence of perioperative myocardial infarction in men undergoing noncardiac surgery [see comments]. Ann Intern Med 1993;118(7):504–510.PubMedGoogle Scholar
  8. 8.
    Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977;297(16):845–850.PubMedCrossRefGoogle Scholar
  9. 9.
    Steen PA, Tinker JH, Tarhan S. Myocardial reinfarction after anesthesia and surgery. JAMA 1978;239(24):2566–2570.PubMedCrossRefGoogle Scholar
  10. 10.
    Tarhan S, Moffitt EA, Taylor WF, Giuliani ER. Myocardial infarction after general anesthesia. JAMA 1972;220(11):1451–1454.PubMedCrossRefGoogle Scholar
  11. 11.
    Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med 1986;1(4):211–219.PubMedCrossRefGoogle Scholar
  12. 12.
    Larsen SF, Olesen KH, Jacobsen E, et al. Prediction of cardiac risk in non-cardiac surgery. Eur Heart J 1987;8(2):179–185.PubMedGoogle Scholar
  13. 13.
    Rao TL, Jacobs KH, El Etr AA. Reinfarction following anesthesia in patients with myocardial infarction. Anesthesiology 1983;59(6):499–505.PubMedCrossRefGoogle Scholar
  14. 14.
    Shah KB, Kleinman BS, Sami H, Patel J, Rao TL. Reevaluation of perioperative myocardial infarction in patients with prior myocardial infarction undergoing noncardiac operations. Anesth Analg 1990;71(3):231–235.PubMedCrossRefGoogle Scholar
  15. 15.
    Crawford ES, Bomberger RA, Glaeser DH, Saleh SA, Russell WL. Aortoiliac occlusive disease: factors influencing survival and function following reconstructive operation over a twenty-five year period. Surgery 1981;90(6):1055–1067.PubMedGoogle Scholar
  16. 16.
    Taylor Jr. LM, Yeager RA, Moneta GL, McConnell DB, Porter JM. The incidence of perioperative myocardial infarction in general vascular surgery. J Vasc Surg 1991;15:52–61.Google Scholar
  17. 17.
    Mamode N, Scott RN, McLaughlin SC, McLelland A, Pollock JG: Perioperative myocardial infarction in peripheral vascular surgery. Br Med J 1996;312(7043):1396–1397.Google Scholar
  18. 18.
    Sprung J, Abdelmakak B, Gottlieb A, Mayhew C, Hammel J, Levy PJ, O’Hara P, Hertzer NR: Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery. Anesthesiology 2000;93:129–140.PubMedCrossRefGoogle Scholar
  19. 19.
    Ashton CM, Petersen NJ, Wray NP, et al. The incidence of perioperative myocardial infarction in men undergoing noncardiac surgery. Ann Intern Med 1993;118:504–510.PubMedGoogle Scholar
  20. 20.
    Badner NH, Knill RL, Brown JE, Novick TV, Gelb AW: Myocardial infarction after noncardiac surgery. Anesthesiology 1998;88:572–578.PubMedCrossRefGoogle Scholar
  21. 21.
    Goldman L, Caldera DL, Southwick FS, et al. Cardiac risk factors and complications in non-cardiac surgery. Medicine (Baltimore) 1978;57(4):357–370.CrossRefGoogle Scholar
  22. 22.
    von Knorring J. Postoperative myocardial infarction: a prospective study in a risk group of surgical patients. Surgery 1981;90(1):55–60.Google Scholar
  23. 23.
    Mangano DT, Browner WS, Hollenberg M, Li J, Tateo IM. Long-term cardiac prognosis following noncardiac surgery. The Study of Perioperative Ischemia Research Group [see comments]. JAMA 1992;268(2):233–239.PubMedCrossRefGoogle Scholar
  24. 24.
    Yeager RA, Moneta GL, Edwards JM, Taylor LM, Jr., McConnell DB, Porter JM. Late survival after perioperative myocardial infarction complicating vascular surgery. J Vasc Surg 1994;20(4):598–604.PubMedGoogle Scholar
  25. 25.
    Gedebou TM, Barr ST, Hunter G, Sinha R, Rappaport W, VillaReal K. Risk factors in patients undergoing major nonvascular abdominal operations that predict perioperative myocardial infarction. Am J Surg. 1997;174(6):755–758.PubMedCrossRefGoogle Scholar
  26. 26.
    Centers for Disease Control and Prevention. Diabetes: Disabling, Deadly, and on the Rise 2003. Available from Accessed
  27. 27.
    Root HF. Preoperative medical care of the diabetic patient. Postgrad Med 1966;40(4):439–444.PubMedGoogle Scholar
  28. 28.
    Sinnock P. Hospital utilization for diabetes. In: Harrison M, Hamman R, editors. Diabetes in America (National Diabetes Data Group), NIH Publication 85-1468. Washington, DC: US Department of Health and Human Services, 1985, pp. XXVI-1–XXVI-11.Google Scholar
  29. 29.
    Salomon NW, Page US, Okies JE, Stephens J, Krause AH, Bigelow JC. Diabetes mellitus and coronary artery bypass. Short-term risk and long-term prognosis. J Thorac Cardiovasc Surg 1983;85(2):264–271.PubMedGoogle Scholar
  30. 30.
    Johnson WD, Pedraza PM, Kayser KL. Coronary artery surgery in diabetics: 261 consecutive patients followed four to seven years. Am Heart J 1982;104(4 Pt 1):823–827.PubMedCrossRefGoogle Scholar
  31. 31.
    Hirsch IB, McGill JB, Cryer PE, White PF. Perioperative management of surgical patients with diabetes mellitus [see comments]. Anesthesiology 1991;74(2):346–359.PubMedCrossRefGoogle Scholar
  32. 32.
    Alberti K, Marshall S. In: Alberti KGM, Krall L, editors. The Diabetes Annual/4. Amsterdam: Elsevier, 1988, pp. 248–271.Google Scholar
  33. 33.
    Eagle KA, Coley CM, Newell JB, et al. Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery. Ann Intern Med 1989;110(11):859–866.PubMedGoogle Scholar
  34. 34.
    Hollenberg M, Mangano DT, Browner WS, London MJ, Tubau JF, Tateo IM. Predictors of postoperative myocardial ischemia in patients undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group [see comments]. JAMA 1992;268(2):205–209.PubMedCrossRefGoogle Scholar
  35. 35.
    Brown KA, Rowen M. Extent of jeopardized viable myocardium determined by myocardial perfusion imaging best predicts perioperative cardiac events in patients undergoing noncardiac surgery. J Am Coll Cardiol 1993;21(2):325–330.PubMedGoogle Scholar
  36. 36.
    Foster ED, Davis KB, Carpenter JA, Abele S, Fray D. Risk of noncardiac operation in patients with defined coronary disease: The Coronary Artery Surgery Study (C ASS) registry experience. Ann Thorac Surg 1986;41(1):42–50.PubMedCrossRefGoogle Scholar
  37. 37.
    Lette J, Waters D, Cerino M, Picard M, Champagne P, Lapointe J. Preoperative coronary artery disease risk stratification based on dipyridamole imaging and a simple three-step, three-segment model for patients undergoing noncardiac vascular surgery or major general surgery. Am J Cardiol 1992;69(19):1553–1558.PubMedCrossRefGoogle Scholar
  38. 38.
    Leppo J, Plaja J, Gionet M, Tumolo J, Paraskos JA, Cutler BS. Noninvasive evaluation of cardiac risk before elective vascular surgery. J Am Coll Cardiol 1987;9(2):269–276.PubMedGoogle Scholar
  39. 39.
    L’Italien GJ, Paul SD, Hendel RC, et al. Development and validation of a Bayesian model for perioperative cardiac risk assessment in a cohort of 1,081 vascular surgical candidates [see comments]. J Am Coll Cardiol 1996;27(4):779–786.PubMedCrossRefGoogle Scholar
  40. 40.
    Pedersen T, Eliasen K, Henriksen E. A prospective study of risk factors and cardiopulmonary complications associated with anaesthesia and surgery: risk indicators of cardiopulmonary morbidity. Acta Anaesthesiol Scand 1990;34(2):144–155.PubMedGoogle Scholar
  41. 41.
    Treiman GS, Treiman RL, Foran RF, Cossman DV, Cohen JL, Levin PM, Wagner WH, Davidson MB: The influence of diabetes mellitus on the risk of abdominal aortic surgery. The Am Surgeon;1994;60:436–440.Google Scholar
  42. 42.
    Melliere D, Berrahal D, Desgranges EA, Becquemin JP, Perlemuter L, Simon D. Influence of diabetes on revascularization procedures of the aorta and lower limb arteries: early results. Eur J Vasc Endovasc Surg; 1999;17:438–441.PubMedCrossRefGoogle Scholar
  43. 43.
    Dardik A, Lin JW, Gordon TA, Williams GM, Perler BA. Results of elective abdominal aortic aneurysm repair in the 1990s: a population-based analysis of 2335 cases. J Vasc Surg; 1999;30:985–95.PubMedCrossRefGoogle Scholar
  44. 44.
    Berry AJ, Smith III RB, Weintraub WS, et al. Age versus comorbidities as risk factors for complications after elective abdominal aortic reconstructive surgery. J Vasc Surg; 2001;33:345–52.PubMedCrossRefGoogle Scholar
  45. 45.
    Ballotta E, Giuseppe DG, Renon L. Is diabetes mellitus a risk factor for carotid endarterectomy? A prospective study. Surgery; 2001;129:146–152.PubMedCrossRefGoogle Scholar
  46. 46.
    Rayan SS, Hamdan AD, Campbell DR, et al. Is diabetes a risk factor for patients undergoing open abdominal aortic aneurysm repair? Vasc Endovasc Surg; 2002;36:33–40.CrossRefGoogle Scholar
  47. 47.
    Hjortrup A, Sorensen C, Dyremose E, Hjortso NC, Kehlet H. Influence of diabetes mellitus on operative risk. Br J Surg 1985;72(10):783–785.PubMedCrossRefGoogle Scholar
  48. 48.
    Mauney FM, Jr., Ebert PA, Sabiston DC, Jr. Postoperative myocardial infarction: a study of predisposing factors, diagnosis and mortality in a high risk group of surgical patients. Ann Surg 1970;172(3):497–503.PubMedCrossRefGoogle Scholar
  49. 49.
    Walsh DB, Eckhauser FE, Ramsburgh SR, Burney RB. Risk associated with diabetes mellitus in patients undergoing gallbladder surgery. Surgery 1982;91(3):254–257.PubMedGoogle Scholar
  50. 50.
    Hertzer NR. Fatal myocardial infarction following peripheral vascular operations. A study of 951 patients followed 6 to 11 years postoperatively. Cleve Clin Q 1982;49(1):1–11.PubMedGoogle Scholar
  51. 51.
    Younis LT, Aguirre F, Byers S, et al. Perioperative and long-term prognostic value of intravenous dipyridamole thallium scintigraphy in patients with peripheral vascular disease. Am Heart J 1990;119(6):1287–1292.PubMedCrossRefGoogle Scholar
  52. 52.
    Ellis SG, Hertzer NR, Young JR, Brener S. Angiographic correlates of cardiac death and myocardial infarction complicating major nonthoracic vascular surgery. Am J Cardiol 1996;77(12):1126–1128.PubMedCrossRefGoogle Scholar
  53. 53.
    Ouyang P, Gerstenblith G, Furman WR, Golueke PJ, Gottlieb SO. Frequency and significance of early postoperative silent myocardial ischemia in patients having peripheral vascular surgery. Am J Cardiol 1989;64(18):1113–1116.PubMedCrossRefGoogle Scholar
  54. 54.
    Fleisher LA, Nelson AH, Rosenbaum SH. Postoperative myocardial ischemia: etiology of cardiac morbidity or manifestation of underlying disease? J Clin Anesth 1995;7(2):97–102.PubMedCrossRefGoogle Scholar
  55. 55.
    Knight MT, Dawson R, Melrose DG. Fibrinolytic response to surgery. Labile and stable patterns and their relevance to post-operative deep venous thrombosis. Lancet 1977;2(8034):370–373.PubMedCrossRefGoogle Scholar
  56. 56.
    Sautter RD, Myers WO, Ray JF, III, Wenzel FJ. Relationship of fibrinolytic system to postoperative thrombotic phenomena. Arch Surg 1973;107(2):292–296.PubMedGoogle Scholar
  57. 57.
    Paramo JA, Alfaro MJ, Rocha E. Postoperative changes in the plasmatic levels of tissue-type plasminogen activator and its fast-acting inhibitor—relationship to deep vein thrombosis and influence of prophylaxis. Thromb Haemost 1985;54(3):713–716.PubMedGoogle Scholar
  58. 58.
    Tuman KJ, McCarthy RJ, March RJ, DeLaria GA, Patel RV, Ivankovich AD. Effects of epidural anesthesia and analgesia on coagulation and outcome after major vascular surgery [see comments]. Anesth Analg 1991;73(6):696–704.PubMedCrossRefGoogle Scholar
  59. 59.
    Dawood MM, Gutpa DK, Southern J, Walia A, Atkinson JB, Eagle KA. Pathology of fatal perioperative myocardial infarction: implications regarding pathophysiology and prevention. Int J Cardiol 1996;57(1):37–44.PubMedCrossRefGoogle Scholar
  60. 60.
    Cohen M, Aretz TSM. Fatal postoperative myocardial infarction is often caused by coronary plaque rupture. J Am Coll Cardiol 1997;29:53A. Abstr.CrossRefGoogle Scholar
  61. 61.
    Garcia MJ, McNamara PM, Gordon T, Kannel WB. Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study. Diabetes 1974;23(2):105–111.PubMedGoogle Scholar
  62. 62.
    National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes in America. 2nd Ed. NIH publication no. 95-1468, 1995, p. 4.Google Scholar
  63. 63.
    Fein FS, Sonnenblick EH. Diabetic cardiomyopathy. Prog Cardiovasc Dis 1985;27(4):255–270.PubMedCrossRefGoogle Scholar
  64. 64.
    Robertson WB, Strong JP. Atherosclerosis in persons with hypertension and diabetes mellitus. Lab Invest 1968;18(5):538–551.PubMedGoogle Scholar
  65. 65.
    Savage MP, Krolewski AS, Kenien GG, Lebeis MP, Christlieb AR, Lewis SM. Acute myocardial infarction in diabetes mellitus and significance of congestive heart failure as a prognostic factor. Am J Cardiol 1988;62(10 Pt 1):665–669.PubMedCrossRefGoogle Scholar
  66. 66.
    Rubler S, Gerber D, Reitano J, Chokshi V, Fisher VJ. Predictive value of clinical and exercise variables for detection of coronary artery disease in men with diabetes mellitus. Am J Cardiol 1987;59(15):1310–1313.PubMedCrossRefGoogle Scholar
  67. 67.
    Lane SE, Lewis SM, Pippin JJ, et al. Predictive value of quantitative dipyridamole-thallium scintigraphy in assessing cardiovascular risk after vascular surgery in diabetes mellitus. Am J Cardiol 1989;64(19):1275–1279.PubMedCrossRefGoogle Scholar
  68. 68.
    Zarich SW, Cohen MC, Lane SE, et al. Routine perioperative dipyridamole 201Tl imaging in diabetic patients undergoing vascular surgery. Diabetes Care 1996;19(4):355–360.PubMedCrossRefGoogle Scholar
  69. 69.
    Nesto RW, Watson FS, Kowalchuk GJ, et al. Silent myocardial ischemia and infarction in diabetics with peripheral vascular disease: assessment by dipyridamole thallium-201 scintigraphy. Am Heart J 1990;120(5):1073–1077.PubMedCrossRefGoogle Scholar
  70. 70.
    Roy TM, Peterson HR, Snider HL, et al. Autonomic influence on cardiovascular performance in diabetic subjects. Am J Med 1989;87(4):382–388.PubMedCrossRefGoogle Scholar
  71. 71.
    Kahn JK, Zola B, Juni JE, Vinik AI. Radionuclide assessment of left ventricular diastolic filling in diabetes mellitus with and without cardiac autonomic neuropathy. J Am Coll Cardiol 1986;7(6):1303–1309.PubMedGoogle Scholar
  72. 72.
    Zola B, Kahn JK, Juni JE, Vinik AI. Abnormal cardiac function in diabetic patients with autonomic neuropathy in the absence of ischemic heart disease. J Clin Endocrinol Metab 1986;63(1):208–214.PubMedGoogle Scholar
  73. 73.
    Niakan E, Harati Y, Rolak LA, Comstock JP, Rokey R. Silent myocardial infarction and diabetic cardiovascular autonomic neuropathy. Arch Intern Med 1986;146(11):2229–2230.PubMedCrossRefGoogle Scholar
  74. 74.
    Murray DP, O’Brien T, Mulrooney R, O’Sullivan DJ. Autonomic dysfunction and silent myocardial ischaemia on exercise testing in diabetes mellitus. Diabet Med 1990;7(7):580–584.PubMedCrossRefGoogle Scholar
  75. 75.
    Ambepityia G, Kopelman PG, Ingram D, Swash M, Mills PG, Timmis AD. Exertional myocardial ischemia in diabetes: a quantitative analysis of anginal perceptual threshold and the influence of autonomic function. J Am Coll Cardiol 1990;15(1):72–77.PubMedGoogle Scholar
  76. 76.
    Ewing DJ, Campbell IW, Clarke BF. The natural history of diabetic autonomic neuropathy. Q J Med 1980;49(193):95–108.PubMedGoogle Scholar
  77. 77.
    Peters A, Kerner W. Perioperative management of the diabetic patient. Exp Clin Endocrinol Diabetes 1995;103(4):213–218.PubMedGoogle Scholar
  78. 78.
    Yue DK, McLennan S, Marsh M, et al. Effects of experimental diabetes, uremia, and malnutrition on wound healing. Diabetes 1987;36(3):295–299.PubMedCrossRefGoogle Scholar
  79. 79.
    Gottrup F, Andreassen TT. Healing of incisional wounds in stomach and duodenum: the influence of experimental diabetes. J Surg Res 1981;31(1):61–68.PubMedCrossRefGoogle Scholar
  80. 80.
    Robertson HD, Polk HC, Jr. The mechanism of infection in patients with diabetes mellitus: a review of leukocyte malfunction. Surgery 1974;75(1):123–128.PubMedGoogle Scholar
  81. 81.
    Bagdade JD, Stewart M, Walters E. Impaired granulocyte adherence. A reversible defect in host defense in patients with poorly controlled diabetes. Diabetes 1978;27(6):677–681.PubMedCrossRefGoogle Scholar
  82. 82.
    Palmisano J. Surgery and Diabetes. In: Kahn C, Weir G, (eds). Joslin’s Diabetes Mellitus. Lea & Febiger, Philadelphia, 1994, pp. 955–961.Google Scholar
  83. 83.
    Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery), 2002.Google Scholar
  84. 84.
    Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). J Am Coll Cardiol 1996;27(4):910–948.PubMedCrossRefGoogle Scholar
  85. 85.
    Palda VA, Detsky AS. Perioperative assessment and management of risk from coronary artery disease. Ann Intern Med 1997;127(4):313–328.PubMedGoogle Scholar
  86. 86.
    MacKenzie CR, Charlson ME. Assessment of perioperative risk in the patient with diabetes mellitus. Surg Gynecol Obstet 1988;167(4):293–299.PubMedGoogle Scholar
  87. 87.
    Farrow SC, Fowkes FG, Lunn JN, Robertson IB, Sweetnam P. Epidemiology in anaesthesia: a method for predicting hospital mortality. Eur J Anaesthesiol 1984;1(1):77–84.PubMedGoogle Scholar
  88. 88.
    Hertzer NR, Beven EG, Young JR, et al. Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management. Ann Surg 1984;199(2):223–233.PubMedCrossRefGoogle Scholar
  89. 89.
    Boucher CA, Brewster DC, Darling RC, Okada RD, Strauss HW, Pohost GM. Determination of cardiac risk by dipyridamole-thallium imaging before peripheral vascular surgery. N Engl J Med 1985;312(7):389–394.PubMedCrossRefGoogle Scholar
  90. 90.
    L’Italien GJ, Cambria RP, Cutler BS, et al. Comparative early and late cardiac morbidity among patients requiring different vascular surgery procedures. J Vasc Surg 1995;21(6):935–944.PubMedCrossRefGoogle Scholar
  91. 91.
    Krupski WC, Layug EL, Reilly LM, Rapp JH, Mangano DT. Comparison of cardiac morbidity rates between aortic and infrainguinal operations: two-year follow-up. Study of Perioperative Ischemia Research Group. J Vasc Surg 1993;18(4):609–615.PubMedCrossRefGoogle Scholar
  92. 92.
    Burgos LG, Ebert TJ, Asiddao C, Turner LA, Pattison CZ, Wang-Cheng R et al. Increased intraoperative cardiovascular morbidity in diabetics with autonomic neuropathy. Anesthesiology 1989;70(4):591–597.PubMedCrossRefGoogle Scholar
  93. 93.
    Vohra A, Kumar S, Charlton AJ, Olukoga AO, Boulton AJ, McLeod D. Effect of diabetes mellitus on the cardiovascular responses to induction of anaesthesia and tracheal intubation. Br J Anaesth 1993;71(2):258–261.PubMedCrossRefGoogle Scholar
  94. 94.
    Charlson ME, MacKenzie CR, Gold JP. Preoperative autonomic function abnormalities in patients with diabetes mellitus and patients with hypertension. J Am Coll Surg 1994;179(1):1–10.PubMedGoogle Scholar
  95. 95.
    Axelrod DA, Upchurch GR Jr, DeMonner S, et al. Perioperative cardiovascular risk stratification of patients with diabetes who undergo elective major vascular surgery. J Vasc Surg; 2002;35:894–901.PubMedCrossRefGoogle Scholar
  96. 96.
    Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation; 1999;100:1043–1049.PubMedGoogle Scholar
  97. 97.
    Nesto RW, Phillips RT. Asymptomatic myocardial ischemia in diabetic patients. Am J Med 1986;80(4C):40–47.PubMedCrossRefGoogle Scholar
  98. 98.
    Nesto RW, Phillips RT, Kett KG, et al. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy [published erratum appears in Ann Intern Med 1988;108(4):646]. Ann Intern Med 1988;108(2):170–175.PubMedGoogle Scholar
  99. 99.
    Kannel WB, Abbott RD. Incidence and prognosis of unrecognized myocardial infarction. An update on the Framingham study. N Engl J Med 1984;311(18):1144–1147.PubMedCrossRefGoogle Scholar
  100. 100.
    Soler NG, Bennett MA, Pentecost BL, Fitzgerald MG, Malins JM. Myocardial infarction in diabetics. Q J Med 1975;44(173):125–132.PubMedGoogle Scholar
  101. 101.
    Uretsky BF, Farquhar DS, Berezin AF, Hood WB, Jr. Symptomatic myocardial infarction without chest pain: prevalence and clinical course. Am J Cardiol 1977;40(4):498–503.PubMedCrossRefGoogle Scholar
  102. 102.
    Carliner NH, Fisher ML, Plotnick GD, et al. Routine preoperative exercise testing in patients undergoing major noncardiac surgery. Am J Cardiol 1985;56(1):51–58.PubMedCrossRefGoogle Scholar
  103. 103.
    Cutler BS, Wheeler HB, Paraskos JA, Cardullo PA. Applicability and interpretation of electrocardiographic stress testing in patients with peripheral vascular disease. Am J Surg 1981;141(4):501–506.PubMedCrossRefGoogle Scholar
  104. 104.
    McPhail N, Calvin JE, Shariatmadar A, Barber GG, Scobie TK. The use of preoperative exercise testing to predict cardiac complications after arterial reconstruction. J Vasc Surg 1988;7(1):60–68.PubMedCrossRefGoogle Scholar
  105. 105.
    Philipson JD, Carpenter BJ, Itzkoff J, et al. Evaluation of cardiovascular risk for renal transplantation in diabetic patients. Am J Med 1986;81(4):630–634.PubMedCrossRefGoogle Scholar
  106. 106.
    Cutler BS, Leppo JA. Dipyridamole thallium 201 scintigraphy to detect coronary artery disease before abdominal aortic surgery. J Vasc Surg 1987;5(1):91–100.PubMedCrossRefGoogle Scholar
  107. 107.
    Sachs RN, Tellier P, Larmignat P, et al. Assessment by dipyridamole-thallium-201 myocardial scintigraphy of coronary risk before peripheral vascular surgery. Surgery 1988;103(5):584–587.PubMedGoogle Scholar
  108. 108.
    Bry JD, Belkin M, O’Donnell TF, Jr., et al. An assessment of the positive predictive value and cost-effectiveness of dipyridamole myocardial scintigraphy in patients undergoing vascular surgery. J Vasc Surg 1994;19(1):112–121.PubMedGoogle Scholar
  109. 109.
    Cutler BS, Hendel RC, Leppo JA. Dipyridamole-thallium scintigraphy predicts perioperative and long-term survival after major vascular surgery. J Vasc Surg 1992;15(6):972–979.PubMedCrossRefGoogle Scholar
  110. 110.
    Hendel RC, Lay den JJ, Leppo JA. Prognostic value of dipyridamole thallium scintigraphy for evaluation of ischemic heart disease [see comments]. J Am Coll Cardiol 1990;15(1):109–116.PubMedCrossRefGoogle Scholar
  111. 111.
    Baron JF, Mundler O, Bertrand M, et al. Dipyridamole-thallium scintigraphy and gated radionuclide angiography to assess cardiac risk before abdominal aortic surgery [see comments]. N Engl J Med 1994;330(10):663–669.PubMedCrossRefGoogle Scholar
  112. 112.
    Mangano DT, London MJ, Tubau JF, et al. Dipyridamole thallium-201 scintigraphy as a preoperative screening test. A reexamination of its predictive potential. Study of Perioperative Ischemia Research Group [see comments]. Circulation 1991;84(2):493–502.PubMedGoogle Scholar
  113. 113.
    Poldermans D, Fioretti PM, Forster T, et al. Dobutamine stress echocardiography for assessment of perioperative cardiac risk in patients undergoing major vascular surgery [see comments]. Circulation 1993;87(5):1506–1512.PubMedGoogle Scholar
  114. 114.
    Eichelberger JP, Schwarz KQ, Black ER, Green RM, Ouriel K. Predictive value of dobutamine echocardiography just before noncardiac vascular surgery. Am J Cardiol 1993;72(7):602–607.PubMedCrossRefGoogle Scholar
  115. 115.
    Pedersen T, Kelbaek H, Munck O. Cardiopulmonary complications in high-risk surgical patients: the value of preoperative radionuclide cardiography. Acta Anaesthesiol Scand 1990;34(3):183–189.PubMedGoogle Scholar
  116. 116.
    Pasternack PF, Imparato AM, Riles TS, Baumann FG, Bear G, Lamparello PJ et al. The value of the radionuclide angiogram in the prediction of perioperative myocardial infarction in patients undergoing lower extremity revascularization procedures. Circulation 1985;72(3 Pt 2):II13–II17.PubMedGoogle Scholar
  117. 117.
    Mosley JG, Clarke JM, Ell PJ, Marston A. Assessment of myocardial function before aortic surgery by radionuclide angiocardiography. Br J Surg 1985;72(11):886–887.PubMedCrossRefGoogle Scholar
  118. 118.
    Eagle KA, Singer DE, Brewster DC, Darling RC, Mulley AG, Boucher CA. Dipyridamole-thallium scanning in patients undergoing vascular surgery. Optimizing preoperative evaluation of cardiac risk. JAMA 1987;257(16):2185–2189.PubMedCrossRefGoogle Scholar
  119. 119.
    Cohen MC, Curran PJ, L’Italien GJ, Mittleman MA, Zarich SW: Long-term prognostic value of preoperative dipyridamole thallium imaging and clinical indexes in patients with diabetes mellitus undergoing peripheral vascular surgery. Am J Cardiol;1999;83:1038–1042.PubMedCrossRefGoogle Scholar
  120. 120.
    Guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of diagnostic and therapeutic cardiovascular procedures (subcommittee on coronary angiography). J Am Coll Cardiol 1987;10(4):935–950.Google Scholar
  121. 121.
    Scanlon PJ, Faxon DP, Audet AM, et al. ACC/AHA guidelines for coronary angiography: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography). Circulation 1999;99:2345–2357.PubMedGoogle Scholar
  122. 122.
    Cohen MC, Eagle KA. Expert opinion regarding indications for coronary angiography before noncardiac surgery. Am Heart J 1997;134(2 Pt 1):321–329.PubMedCrossRefGoogle Scholar
  123. 123.
    Braun WE, Phillips DF, Vidt DG, et al. Coronary artery disease in 100 diabetics with end-stage renal failure. Transplant Proc 1984;16(3):603–607.PubMedGoogle Scholar
  124. 124.
    Bennett WM, Kloster F, Rosch J, Barry J, Porter GA. Natural history of asymptomatic coronary arteriographic lesions in diabetic patients with end-stage renal disease. Am J Med 1978;65(5):779–784.PubMedCrossRefGoogle Scholar
  125. 125.
    Braun WE, Phillips D, Vidt DG, et al. Coronary arteriography and coronary artery disease in 99 diabetic and nondiabetic patients on chronic hemodialysis or renal transplantation programs. Transplant Proc 1981;13(1 Pt 1):128–135.PubMedGoogle Scholar
  126. 126.
    Weinrauch L, D’Elia JA, Healy RW, Gleason RE, Christleib AR, Leland OS Jr. Asymptomatic coronary artery disease: angiographic assessment of diabetics evaluated for renal transplantation. Circulation 1978;58(6):1184–1190.PubMedGoogle Scholar
  127. 127.
    Lindner A, Charra B, Sherrard DJ, Scribner BH. Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Engl J Med 1974;290(13):697–701.PubMedCrossRefGoogle Scholar
  128. 128.
    Khauli RB, Steinmuller DR, Novick AC, et al. A critical look at survival of diabetics with end-stage renal disease. Transplantation versus dialysis therapy. Transplantation 1986;41(5):598–602.PubMedCrossRefGoogle Scholar
  129. 129.
    Brown KA, Rimmer J, Haisch C. Noninvasive cardiac risk stratification of diabetic and nondiabetic uremic renal allograft candidates using dipyridamole-thallium-201 imaging and radionuclide ventriculography. Am J Cardiol 1989;64(16):1017–1021.PubMedCrossRefGoogle Scholar
  130. 130.
    Camp AD, Garvin PJ, Hoff J, Marsh J, Byers SL, Chaitman BR. Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation. Am J Cardiol 1990;65(22):1459–1463.PubMedCrossRefGoogle Scholar
  131. 131.
    Ibels LS, Stewart JH, Mahony JF, Sheil AG. Deaths from occlusive arterial disease in renal allograft recipients. Br Med J 1974;3(5930):552–554.PubMedGoogle Scholar
  132. 132.
    Washer GF, Schroter GP, Starzl TE, Weil R, III. Causes of death after kidney transplantation. JAMA 1983;250(1):49–54.PubMedCrossRefGoogle Scholar
  133. 133.
    Rao KV, Andersen RC. The impact of diabetes on vascular complications following cadaver renal transplantation. Transplantation 1987;43(2):193–197.PubMedCrossRefGoogle Scholar
  134. 134.
    Sutherland DE, Goetz C, Najarian JS. Pancreas transplantation at the University of Minnesota: donor and recipient selection, operative and postoperative management, and outcome. Transplant Proc 1987;19(4Suppl4):63–74.PubMedGoogle Scholar
  135. 135.
    Manske CL, Wang Y, Thomas W. Mortality of cadaveric kidney transplantation versus combined kidney-pancreas transplantation in diabetic patients [see comments]. Lancet 1995;346(8991–8992):1658–1662.PubMedCrossRefGoogle Scholar
  136. 136.
    Morrow CE, Schwartz JS, Sutherland DE, et al. Predictive value of thallium stress testing for coronary and cardiovascular events in uremic diabetic patients before renal transplantation. Am J Surg 1983;146(3):331–335.PubMedCrossRefGoogle Scholar
  137. 137.
    Mayer G, Thum J, Cada EM, Stummvoll HK, Graf H. Working capacity is increased following recombinant human erythropoietin treatment. Kidney Int 1988;34(4):525–528.PubMedCrossRefGoogle Scholar
  138. 138.
    Ohmura N, Ohta M, Tamura H, Kawaguchi Y, Miyahara T. The influence of dialysis solution on the exercise capacity in patients on CAPD. In: Khanna R, Nolph K, Prowant B, Twardowski Z, Oreopoulos D, (eds). Advances in peritoneal dialysis. University of Toronto Press, Toronto, Canada, 1989, pp. 46–48.Google Scholar
  139. 139.
    Marwick TH, Steinmuller DR, Underwood DA, et al. Ineffectiveness of dipyridamole SPECT thallium imaging as a screening technique for coronary artery disease in patients with end-stage renal failure. Transplantation 1990;49(1):100–103.PubMedCrossRefGoogle Scholar
  140. 140.
    Holley JL, Fenton RA, Arthur RS. Thallium stress testing does not predict cardiovascular risk in diabetic patients with end-stage renal disease undergoing cadaveric renal transplantation. Am J Med 1991;90(5):563–570.PubMedCrossRefGoogle Scholar
  141. 141.
    Melissinos K, Delidou A, Grammenou S, Markopoulos P. Study of the activity of lymphocyte adenosine deaminase in chronic renal failure. Clin Chim Acta 1983;135(1):9–12.PubMedCrossRefGoogle Scholar
  142. 142.
    Lorber MI, Van Buren CT, Flechner SM, et al. Pretransplant coronary arteriography for diabetic renal transplant recipients. Transplant Proc 1987;19(1 Pt 2):1539–1541.PubMedGoogle Scholar
  143. 143.
    Lemmers MJ, Barry JM. Major role for arterial disease in morbidity and mortality after kidney transplantation in diabetic recipients. Diabetes Care 1991;14(4):295–301.PubMedCrossRefGoogle Scholar
  144. 144.
    Friedman E. Management of diabetes and diabetic complications in patients with diabetic renal disease. In: Jacobson H, Striker G, Klahr S, (eds). Principles and practice of nephrology. BC Decker Inc., Philadelphia, 1991, pp. 483–491.Google Scholar
  145. 145.
    Manske CL, Wang Y, Rector T, Wilson RF, White CW. Coronary revascularisation in insulin-dependent diabetic patients with chronic renal failure. Lancet 1992;340(8826):998–1002.PubMedCrossRefGoogle Scholar
  146. 146.
    Stone JG, Foex P, Sear JW, Johnson LL, Khambatta HJ, Triner L. Myocardial ischemia in untreated hypertensive patients: effect of a single small oral dose of a beta-adrenergic blocking agent. Anesthesiology 1988;68(4):495–500.PubMedCrossRefGoogle Scholar
  147. 147.
    Pasternack PF, Imparato AM, Baumann FG, et al. The hemodynamics of beta-blockade in patients undergoing abdominal aortic aneurysm repair. Circulation 1987;76(3 Pt 2):III1–III7.PubMedGoogle Scholar
  148. 148.
    Pasternack PF, Grossi EA, Baumann FG, et al. Beta blockade to decrease silent myocardial ischemia during peripheral vascular surgery. Am J Surg 1989;158(2):113–116.PubMedCrossRefGoogle Scholar
  149. 149.
    Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group [see comments] [published erratum appears in N Engl J Med 1997;336(14):1039]. N Engl J Med 1996;335(23):1713–1720.PubMedCrossRefGoogle Scholar
  150. 150.
    Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on preoperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. N Engl J Med 1999;341:1789–1794.PubMedCrossRefGoogle Scholar
  151. 151.
    Boersma E, Poldermans D, Bax JJ, et al. Predictors of cardiac events after major vascular surgery: role of clinical characteristics, dobutamine echocardiography, and [beta]-blocker therapy. JAMA 2001;285(14):1865–1873.PubMedCrossRefGoogle Scholar
  152. 152.
    Christleib A. Hypertension in the diabetic patient. In: Kahn C, Weir G, (eds). Joslin’s Diabetes Mellitus. Lea & Febiger, Philadelphia, 1985:538–599.Google Scholar
  153. 153.
    Shorr RI, Ray WA, Daugherty JR, Griffin MR. Antihypertensives and the risk of serious hypoglycemia in older persons using insulin or sulfonylureas [see comments]. JAMA 1997;278(1):40–43.PubMedCrossRefGoogle Scholar
  154. 154.
    Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. UK Prospective Diabetes Study Group [see comments]. BMJ 1998;317(7160):713–720.Google Scholar
  155. 155.
    Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group [see comments] [published erratum appears in BMJ 1999;318(7175):29]. BMJ 1998;317(7160):703–713.Google Scholar
  156. 156.
    Jonas M, Reicher-Reiss H, Boyko V, et al. Usefulness of beta-blocker therapy in patients with non-insulin-dependent diabetes mellitus and coronary artery disease. Bezafibrate Infarction Prevention (BIP) Study Group. Am J Cardiol 1996;77(15):1273–1277.PubMedCrossRefGoogle Scholar
  157. 157.
    Kjekshus J, Gilpin E, Cali G, Blackey AR, Henning H, Ross J Jr. Diabetic patients and beta-blockers after acute myocardial infarction. Eur Heart J 1990;11(1):43–50.PubMedGoogle Scholar
  158. 158.
    Malmberg K, Herlitz J, Hjalmarson A, Ryden L. Effects of metoprolol on mortality and late infarction in diabetics with suspected acute myocardial infarction. Retrospective data from two large studies. Eur Heart J 1989;10(5):423–428.PubMedGoogle Scholar
  159. 159.
    Rodda BE. The Timolol Myocardial Infarction Study: an evaluation of selected variables. Circulation 1983;67(6 Pt 2):I101–I106.PubMedGoogle Scholar
  160. 160.
    Furberg CD, Byington RP. What do subgroup analyses reveal about differential response to beta-blocker therapy? The Beta-Blocker Heart Attack Trial experience. Circulation 1983;67(6 Pt 2):I98–I101.PubMedGoogle Scholar
  161. 161.
    Coriat P, Daloz M, Bousseau D, Fusciardi J, Echter E, Viars P. Prevention of intraoperative myocardial ischemia during noncardiac surgery with intravenous nitroglycerin. Anesthesiology 1984;61(2):193–196.PubMedCrossRefGoogle Scholar
  162. 162.
    Dodds TM, Stone JG, Coromilas J, Weinberger M, Levy DG. Prophylactic nitroglycerin infusion during noncardiac surgery does not reduce perioperative ischemia [see comments]. Anesth Analg 1993;76(4):705–713.PubMedCrossRefGoogle Scholar
  163. 163.
    Cohen MM, Duncan PG, Tate RB. Does anesthesia contribute to operative mortality? [see comments]. JAMA 1988;260(19):2859–2863.PubMedCrossRefGoogle Scholar
  164. 164.
    Slogoff S, Keats AS. Randomized trial of primary anesthetic agents on outcome of coronary artery bypass operations. Anesthesiology 1989;70(2):179–188.PubMedCrossRefGoogle Scholar
  165. 165.
    Kehlet H. Epidural analgesia and the endocrine-metabolic response to surgery. Update and perspectives. Acta Anaesthesiol Scand 1984;28(2):125–127.PubMedGoogle Scholar
  166. 166.
    Shirasaka C, Tsuji H, Asoh T, Takeuchi Y. Role of the splanchnic nerves in endocrine and metabolic response to abdominal surgery. Br J Surg 1986;73(2):142–145.PubMedCrossRefGoogle Scholar
  167. 167.
    Christopherson R, Beattie C, Frank SM, et al. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Perioperative Ischemia Randomized Anesthesia Trial Study Group [see comments]. Anesthesiology 1993;79(3):422–434.PubMedCrossRefGoogle Scholar
  168. 168.
    Baron JF, Bertrand M, Barre E, et al. Combined epidural and general anesthesia versus general anesthesia for abdominal aortic surgery. Anesthesiology 1991;75(4):611–618.PubMedCrossRefGoogle Scholar
  169. 169.
    Bode RH, Jr., Lewis KP, Zarich SW, et al. Cardiac outcome after peripheral vascular surgery. Comparison of general and regional anesthesia [see comments]. Anesthesiology 1996;84(1):3–13.PubMedCrossRefGoogle Scholar
  170. 170.
    Janda A, Salem C. [Hypoglycemia caused by lidocaine overdosage]. Reg Anaesth 1986;9(3):88–90.PubMedGoogle Scholar
  171. 171.
    Romano E, Gullo A. Hypoglycaemic coma following epidural analgesia. Anaesthesia 1980;35(11):1084–1086.PubMedCrossRefGoogle Scholar
  172. 172.
    Pierce E. Anesthesia in the diabetic. In: Kozak G, (ed). Clinical diabetes mellitus. WB Saunders, Philadelphia, 1982, pp. 246–251.Google Scholar
  173. 173.
    Grayburn PA, Hillis DL. Cardiac events in patients undergoing noncardiac surgery: shifting the paradigm from noninvasive risk stratification to therapy. Ann Intern Med 2003;138:506–511.PubMedGoogle Scholar
  174. 174.
    Hertzer NR, Young JR, Beven EG, et al. Late results of coronary bypass in patients with peripheral vascular disease. I. Five-year survival according to age and clinical cardiac status. Cleve Clin Q 1986;53(2):133–143.PubMedGoogle Scholar
  175. 175.
    Long-term results of prospective randomised study of coronary artery bypass surgery in stable angina pectoris. European Coronary Surgery Study Group. Lancet 1982;2(8309):1173–1180.Google Scholar
  176. 176.
    McFalls EO, Ward HB, Santilli S, Scheftel M, Chesler E, Doliszny K. The influence of perioperative myocardial infarction on long-term prognosis following elective vascular surgery. Chest 1998;113(3):681–686.PubMedGoogle Scholar
  177. 177.
    Stein B, Weintraub WS, Gebhart SP, et al. Influence of diabetes mellitus on early and late outcome after percutaneous transluminal coronary angioplasty. Circulation 1995;91(4):979–989.PubMedGoogle Scholar
  178. 178.
    Brandrup-Wognsen G, Haglid M, Karlsson T, Berggren H, Herlitz BJ. Preoperative risk indicators of death at an early and late stage after coronary artery bypass grafting. Thorac Cardiovasc Surg 1995;43(2):77–82.PubMedCrossRefGoogle Scholar
  179. 179.
    Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI) [see comments]. Circulation 1997;96(6):1761–1769.Google Scholar
  180. 180.
    Kelsey SF. Patients with diabetes did better with coronary bypass graft surgery than with percutaneous transluminal coronary angioplasty: was this BARI finding real? Am Heart J 1999;138:S387–S393.PubMedCrossRefGoogle Scholar
  181. 181.
    Elmore JR, Hallett JW Jr, et al. Myocardial revascularization before abdominal aortic aneurysmorrhaphy: effect of coronary angioplasty [see comments]. Mayo Clin Proc 1993;68(7):637–641.PubMedGoogle Scholar
  182. 182.
    Huber KC, Evans MA, Bresnahan JF, Gibbons RJ, Holmes DR Jr. Outcome of noncardiac operations in patients with severe coronary artery disease successfully treated preoperatively with coronary angioplasty [see comments]. Mayo Clin Proc 1992;67(1):15–21.PubMedGoogle Scholar
  183. 183.
    Jones SE, Raymond RE, Simpfendorfer CC, Whitlow PL. Cardiac outcome of major noncardiac surgery in patients undergoing preoperative coronary angioplasty. J Invasive Cardiol 1993;5(6):212–218.PubMedGoogle Scholar
  184. 184.
    Allen JR, Helling TS, Hartzler GO. Operative procedures not involving the heart after percutaneous transluminal coronary angioplasty. Surg Gynecol Obstet 1991;173(4):285–288.PubMedGoogle Scholar
  185. 185.
    Kaluza GL, Joseph J, Lee JR, Raizner ME, Raizner AE. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 2000;35:1288–1294.PubMedCrossRefGoogle Scholar
  186. 186.
    Wilson SH, Fasseas P, Orford JL, et al. Clinical outcomes of patients undergoing non-cardiac surgery in the two months following coronary stenting. J Am Coll Cardiol 2003;42:234–240.PubMedCrossRefGoogle Scholar
  187. 187.
    Joyce WP, Provan JL, Ameli FM, McEwan MM, Jelenich S, Jones DP. The role of central haemodynamic monitoring in abdominal aortic surgery. A prospective randomised study. Eur J Vasc Surg 1990;4(6):633–636.PubMedCrossRefGoogle Scholar
  188. 188.
    Isaacson IJ, Lowdon JD, Berry AJ, Smith RB, III, Knos GB, Weitz FI et al. The value of pulmonary artery and central venous monitoring in patients undergoing abdominal aortic reconstructive surgery: a comparative study of two selected, randomized groups. J Vasc Surg 1990;12(6):754–760.PubMedCrossRefGoogle Scholar
  189. 189.
    Berlauk JF, Abrams JH, Gilmour IJ, O’Connor SR, Knighton DR, Cerra FB. Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery. A prospective, randomized clinical trial [see comments]. Ann Surg 1991;214(3):289–297.PubMedCrossRefGoogle Scholar
  190. 190.
    Practice guidelines for pulmonary artery catheterization. A report by the American Society of Anesthesiologists Task Force on Pulmonary Artery Catheterization [see comments]. Anesthesiology 1993;78(2):380–394.Google Scholar
  191. 191.
    Rettke SR, Shub C, Naessens JM, Marsh HM, O’Brien JF. Significance of mildly elevated creatine kinase (myocardial band) activity after elective abdominal aortic aneurysmectomy. J Cardiothorac Vasc Anesth 1991;5(5):425–430.PubMedCrossRefGoogle Scholar
  192. 192.
    Charlson ME, MacKenzie CR, Ales K, Gold JP, Fairclough G Jr, Shires GT. Surveillance for postoperative myocardial infarction after noncardiac operations. Surg Gynecol Obstet 1988;167(5):407–414.PubMedGoogle Scholar
  193. 193.
    Adams JE, Sicard GA, Allen BT, et al. Diagnosis of peri operative myocardial infarction with measurement of cardiac troponin I. N Engl J Med 1994;330:670–674.PubMedCrossRefGoogle Scholar
  194. 194.
    Lopez-Jimenez F, Goldman L, Sacks DB, Thomas EJ, Johnson PA, Cook EF, Lee TH. Prognostic value of cardiac troponin T after noncardiac surgery: 6-month follow-up data. J Am Coll Cardiol 1997;29:1241–1245.PubMedCrossRefGoogle Scholar
  195. 195.
    Metzler H, Gries M, Rehak P, Lang TH, Fruhwald S, Toller W. Perioperative myocardial cell injury: the role of troponins. Br J Anaesth 1997;78:386–390.PubMedGoogle Scholar
  196. 196.
    Lee TH, Thomas EJ, Ludwig LE, et al. Troponin T as a marker for myocardial ischemia in patients undergoing major noncardiac surgery. Am J Cardiol 1996;77:1031–1036.PubMedCrossRefGoogle Scholar
  197. 197.
    Badner NH, Knill RL, Brown JE, Novick TV, Gelb AW. Myocardial infarction after noncardiac surgery. Anesthesiology 1998;88:572–578.PubMedCrossRefGoogle Scholar
  198. 198.
    Godet G, Ayed SB, Bernard M, et al. Cardiac troponin I cutoff values to predict postoperative cardiac complications after circulatory arrest and profound hypothermia. J Cardiothorac Vasc Anesth 1999;13:272–275.PubMedCrossRefGoogle Scholar
  199. 199.
    Benoit MO, Paris M, Silleran J, Fiemeyer A, Moatti N. Cardiac troponin I: its contribution to the diagnosis of preoperative myocardial infarction and various complications of cardiac surgery. Crit Care Med 2001;29(10):1880–1886.PubMedCrossRefGoogle Scholar
  200. 200.
    Mangano DT, Browner WS, Hollenberg M, London MJ, Tubau JF, Tateo IM. Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group [see comments]. N Engl J Med 1990;323(26):1781–1788.PubMedCrossRefGoogle Scholar
  201. 201.
    Landesberg G, Luria MH, Cotev S, et al. Importance of long-duration postoperative ST-segment depression in cardiac morbidity after vascular surgery [see comments]. Lancet 1993;341(8847):715–719.PubMedCrossRefGoogle Scholar
  202. 202.
    Fleisher LA, Zielski MM, Schulman SP. Perioperative ST-segment depression is rare and may not indicate myocardial ischemia in moderate-risk patients undergoing noncardiac surgery. J Cardiothorac Vasc Anesth 1997;11(2):155–159.PubMedCrossRefGoogle Scholar
  203. 203.
    Golden SH, Peart-Vigilance C, Kao WHL, Brancati FL. Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care 1999;22:1408–1414.PubMedCrossRefGoogle Scholar
  204. 204.
    Furnary AP, Zerr KJ, Grunkemeier GL, Starr A. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg 1999;67:352–362.PubMedCrossRefGoogle Scholar
  205. 205.
    Rassias AJ, Marrin CAS, Arruda J, Whalen PK, Beach M, Yeager MP. Insulin infusion improves neutrophil function in diabetic cardiac surgery patients. Anesth Analg. 1999;88:1011–1016.PubMedCrossRefGoogle Scholar
  206. 206.
    Gill GV, Sherif IH, Alberti KG. Management of diabetes during open heart surgery. Br J Surg 1981;68(3):171–172.PubMedCrossRefGoogle Scholar
  207. 207.
    Taitelman U, Reece EA, Bessman AN. Insulin in the management of the diabetic surgical patient: continuous intravenous infusion vs subcutaneous administration. JAMA 1977;237(7):658–660.PubMedCrossRefGoogle Scholar
  208. 208.
    Pezzarossa A, Taddei F, Cimicchi MC, Rossini E, Contini S, Bonora E et al. Perioperative management of diabetic subjects. Subcutaneous versus intravenous insulin administration during glucose-potassium infusion. Diabetes Care 1988;11(1):52–58.PubMedCrossRefGoogle Scholar
  209. 209.
    Goldberg NJ, Wingert TD, Levin SR, Wilson SE, Viljoen JF. Insulin therapy in the diabetic surgical patient: metabolic and hormone response to low dose insulin infusion. Diabetes Care 1981;4(2):279–284.PubMedGoogle Scholar
  210. 210.
    Alberti KG, Gill GV, Elliott MJ. Insulin delivery during surgery in the diabetic patient. Diabetes Care 1982;(5 Suppl 1):65–77.PubMedGoogle Scholar
  211. 211.
    Goldman L, Lee T, Rudd P. Ten commandments for effective consultations. Arch Intern Med 1983;143(9):1753–1755.PubMedCrossRefGoogle Scholar
  212. 212.
    Horwitz RI, Henes CG, Horwitz SM. Developing strategies for improving the diagnostic and management efficacy of medical consultations. J Chronic Dis 1983;36(2):213–218.PubMedCrossRefGoogle Scholar
  213. 213.
    Mangano DT, Goldman L. Preoperative assessment of patients with known or suspected coronary disease. N Engl J Med 1995;333(26):1750–1756.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2005

Authors and Affiliations

  • Alanna Coolong
    • 1
  • Mylan C. Cohen
    • 2
    • 3
  1. 1.Division of CardiologyMaine Medical CenterPortland
  2. 2.Maine Cardiology AssociatesMaine Medical CenterPortland
  3. 3.Department of MedicineUniversity of Vermont College of MedicineBurlington

Personalised recommendations