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Zia Ullah
Dr Muhammad Ammar
Wajiha Arshad
Dr. Sahab Ahmad
Dr. Nayab Tufail
Dr Jassim Zaheen Shah
Shiv Ram Ashraf
Khurram Shahzad


Cardiac Surgery, Mortality, Pre-Diabetics, Heart Failure


Background: Heart failure is a major public health concern affecting millions of individuals worldwide. Patients with pre-diabetes face an elevated risk of developing heart failure due to their impaired glucose metabolism. Cardiac surgery has been a vital therapeutic intervention for managing heart failure in this population; however, the extent of its impact on mortality rates remains a subject of ongoing research and debate.

Aim: This study aims to assess the effect of cardiac surgery on mortality rates in pre-diabetic patients with heart failure through a comprehensive meta-analysis of relevant literature. A systematic search was conducted across various databases, identifying a total of 15 observational studies and randomized controlled trials that met the inclusion criteria. These studies encompassed a combined sample size of 5,000 pre-diabetic patients with heart failure, who underwent different types of cardiac surgeries, including coronary artery bypass grafting (CABG) and valve repair/replacement procedures.

Methods: The meta-analysis revealed a statistically significant reduction in mortality rates following cardiac surgery in pre-diabetic patients with heart failure. The overall pooled mortality rate post-surgery was 30% lower compared to pre-surgery mortality rates. Subgroup analyses also demonstrated that CABG procedures were associated with a more pronounced reduction in mortality compared to valve repair/replacement surgeries.

Results: Furthermore, the meta-analysis explored potential modifiers of the surgery-mortality relationship, such as age, gender, and left ventricular ejection fraction. These analyses provided insights into patient characteristics that could influence the surgical outcomes in this vulnerable population. However, this study has certain limitations, including the heterogeneity of the included studies, variable follow-up periods, and potential publication bias. Additional research is needed to address these limitations and gain a deeper understanding of the mechanisms underlying the observed mortality reduction.

Conclusion: In conclusion, cardiac surgery demonstrates a significant impact on reducing mortality rates in pre-diabetic patients with heart failure. This finding underscores the importance of considering surgical interventions as part of a comprehensive treatment approach for managing heart failure in pre-diabetic individuals. By improving patient outcomes and survival, cardiac surgery holds promise as a valuable therapeutic strategy in this high-risk population. Nevertheless, further investigations and long-term studies are warranted to consolidate these findings and inform evidence-based clinical decision-making.

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