Association of Preoperative Hemoglobin A1c with In-hospital Mortality Following Valvular Heart Surgery

Abstract

Objective To determine the association between the preoperative level of hemoglobin A1c (HbA1c) and in-hospital mortality in patients who underwent valvular heart surgery in our center in a retrospective cohort. Methods In this retrospective consecutive cohort study, patients with type 2 diabetes mellitus who were referred to our center for elective valvular surgery were enrolled and followed up. The endpoint of this study was in-hospital mortality. Based on the level of HbA1c, patients were dichotomized around a level of 7% into two groups: exposed patients with HbA1c ≥ 7% and unexposed patients with HbA1c < 7%. Then, the study variables were compared between the two groups. Results Two hundred twenty-four diabetic patients who were candidates for valvular surgery were enrolled; 106 patients (47.3%) had HbA1c < 7%, and 118 patients (52.6%) had HbA1c ≥ 7%. The duration of diabetes was higher in patients with HbA1c ≥ 7% ( P =0.007). Thirteen (5.8%) patients died during hospital admission, of which nine patients were in the high HbA1c group. There was no significant difference between the groups regarding in-hospital mortality ( P =0.899). Both the unadjusted and adjusted logistic regression models showed that HbA1c was not a predictor for in-hospital mortality ( P =0.227 and P =0.388, respectively) Conclusion This study showed no association between preoperative HbA1c levels and in-hospital mortality in candidates for valvular heart surgery.

Prevalence and Predictive Factors of Early Degeneration of Bioprosthetic Mitral Valves: A Single-Center Cohort Study

“…Although previously reported, we did not fnd any association between classic cardiovascular risk factors and early degeneration [38]. Our fndings align with our previous study on the association between diabetes mellitus and complications following valvular heart surgery [40]. To fully understand this association, we believe several factors, such as blood glucose levels, hemoglobin A1c, duration of diabetes, and type of antiglycemic treatment, should be considered simultaneously to reach a precise conclusion.…”

Incidence of Superficial and Deep Surgical Site Infections in Post Cardiac Surgery Patients with Pre-Operative HBA1C ≥ 7 % Compared to Those Having Pre-Operative HBAIC < 7%

“…Other than increasing oxidative stress and inflammatory markers, hyperglycemia also harms the immune system by disrupting chemotaxis, phagocytosis, and overproduction of free fatty acids. All these factors altogether may lead to an increased risk of developing SSI [18][19][20] .…”

Predictive power of elevated preoperative HbA1c levels for postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass surgery—Many questions to be asked and many answers to be given

“…Control of blood glucose in patients who undergo any surgical operation is crucial as DM has been linked to the development of many adverse outcomes following open‐heart surgeries. Actually, since HbA1c has been considered to be the best marker to assess glycemic control as it reflects a time‐weighted mean over the previous 3–4 months, it was predicted that elevated levels of this molecule could be linked with prognosis, major adverse events and morbidity, as an indicator of poor glycemic control 2 . Evidence implies that the reversal of microvascular changes by lowering HbA1c before cardiac surgery may decrease risks.…”