Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery

Abstract

Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 ± 1.7%, where 206 (35.6%) patients had an HbA1c ≤ 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c ≤ 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.

Health Behavior, Level of Hemoglobin A1c, and Quality of Life Among Agricultural Workers of Various Ethnicities in Thai Border Communities

“…Studies have suggested that a high blood sugar level is an independent predictor of cardiovascular disease regardless of the diagnosis of DM ( 50 – 52 ). One study suggested that the perception of disease and self-care behaviors were predictive factors significantly associated with the HbA1c level ( 36 ).…”

Investigation of the association between serum HbA1c level and hemodynamic variables in diabetic patients undergoing prostatectomy

“…It can cause postoperative complications such as wound infection, delayed wound healing, and dehydration, highlighting the need for more careful control of blood glucose in these patients . Muhammad Abu Tailakh et al indicated that diabetic patients with ME HbA1c > 7% after elective coronary artery bypass graft surgery had a more 5-year mortality rate than healthy individuals, indicating the importance of long-term blood glucose control to reduce stress-related complications such as heart surgery in diabetic patients [24]. In a study conducted on 409 patients who underwent heart surgery, Gandhi et al showed that per 20 mg of increase in blood glucose above 100 mg during surgery, respiratory and renal complications increase by 30% [25].…”

The Role of Insulin Resistance in the Development of Complications after Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease

“…Moreover, the frequency of DM among these patients continues to grow along with an increase in the prevalence of DM among the general population [3]. Since the presence of concomitant DM not only affects the choice of the myocardial revascularization strategy [4,5], but also the prognosis after such interventions [6], attention is now being paid not only to the presence of DM, but also to the degree of glycemic control [7][8][9]. In addition, since even the presence of prediabetes can affect the prognosis in cardiac patients [10], active screening of early carbohydrate metabolism disorders before coronary interventions is justified [11][12][13].…”