Effect of preoperative glycemic status on postoperative complications of coronary artery bypass graft surgery in patients with diabetes

Abstract

Objectives: Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA1c is a measure of glycemic control. This study aimed to determine the effect of glycemic status on the complications of coronary artery bypass graf (CABG) surgery in diabetic patients.
 Methods: This cross-sectional study was performed on 300 diabetic patients including 186 (62%) men and 114 (38%) women who underwent CABG from March 2010 to August 2011 and selected via census method. Preoperative blood glucose control status was determined using HbA1c levels, and the patients were evaluated for postoperative in-hospital complications.
 Results: The mean age of the patients was 62.3± 6.9 years. In-hospital mortality was 1.0% (3/300). New-onset atrial fibrillation was the most common complication (35%). HbA1c level above 7.5% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio 1.9, 95٪ CI: 1.1-3.2, p = 0.006). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA1c level in two groups with or without complication.
 Conclusions: Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA1c measurement can be a predictor of high-risk patients.

The connotation between perioperative glycemic control approach and sternal wound infection in individuals with diabetes mellitus experiencing cardiac surgery: A meta‐analysis

“…12 publications from a total of 2654 connected investigations that were examined that met the inclusion criteria and were published between 2004 and 2021 were chosen and included in the investigation 12,13,19‐28 . The results of these researches are presented in Table 2.…”

“…12 publications from a total of 2654 connected investigations that were examined that met the inclusion criteria and were published between 2004 and 2021 were chosen and included in the investigation. 12,13,[19][20][21][22][23][24][25][26][27][28] The results of these researches are presented in Table 2. 1564 individuals with DM and CS were in the chosen investigations' T A B L E 2 Characteristics of the selected investigations for the metaanalysis.…”

“…In investigations that were considered for the meta‐analysis, 1564 individuals with DM and CS were in the chosen investigations' starting point, 790 of them were using strict GC, and 774 were using moderate GC 12,13,19‐28 . Strict GC had significantly lower SWI compared with those with moderate GC in individuals with DM and CS.…”

“…In investigations that were considered for the meta-analysis, 1564 individuals with DM and CS were in the chosen investigations' starting point, 790 of them were using strict GC, and 774 were using moderate GC. 12,13,[19][20][21][22][23][24][25][26][27][28] Strict GC had significantly lower SWI compared with those with moderate GC in individuals with DM and CS. Although precautions must be exercised when dealing with its values because some of the selected investigations for this meta-analysis were with a low sample size (4 out of 12 were ≤ 100 individuals).…”

Effects of glargine on hyperglycemia in patients with diabetes mellitus type II undergoing off-pump coronary artery bypass graft: A randomized, controlled, double-blind clinical trial

“… 4 - 7 Based on the available evidence, reducing perioperative complications and improvement of short- and long-term survival can be achieved by glycemic control in diabetic patients undergoing CABG. 4 , 6 , 8 …”