Influence of preoperative hemoglobin A1c on early outcomes in patients with diabetes mellitus undergoing off-pump coronary artery bypass surgery

Commentary: Optimize preoperative glycemic control or carry on as usual?

“…In the investigation by Kim and colleagues, the odds of patients with diabetes experiencing an adverse outcome perioperatively was statistically significant, although somewhat low. 4 Furthermore, the discriminative ability of HbA1c was as good as flipping a coin to predict short-term outcomes (area under the receiving operative curve: 0.55 for an HbA1c of 7.85%). We can then ask whether surgery should be delayed or carry on as usual despite poor management of glycemic control.…”

Commentary: Addressing glycemic load in the precardiac surgical period: Does one size fit all?

“…3 Off-pump coronary artery bypass may also be preferred when HbA1c levels are above critical thresholds (7.0%) for adverse surgical outcomes. 4 Many patients included in the metaanalysis had diabetes mellitus; therefore, the extent to which novel antihyperglycemic agents (glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter-2 inhibitors) known to reduce the risk of major adverse cerebrovascular and cardiovascular events impact the HbA1c-postoperative risk relationship warrants further investigation. 5 Maintenance of long-term glycemic control is needed to improve prognosis regardless of diabetes status, yet this goal is not always met.…”

Outcome-relevante Faktoren in der Wirbelsäulenchirurgie

“…Denkbar wären Assoziationen zwischen den prä-und postoperativen HbA 1c -Werten und dem Outcome, wie dies z. B. bei koronaren Bypassoperationen nachgewiesen werden konnte [67].…”