Preoperative Glycosylated Hemoglobin: A Risk Factor for Patients Undergoing Coronary Artery Bypass

Abstract

An HbA1c level of 6.5% or higher in patients presenting for coronary artery bypass grafting was associated with a significant increase in the incidence of deep sternal wound infection and respiratory complications.

Effect of glycemic control on mortality and infections in patients undergoing coronary artery bypass grafting: a Genesee County experience

“…Halkos et al [12] reported a linearly increasing mortality with increasing HbA1c and a four-fold increase in mortality in patients with HbA1c >8.6%. Similarly, Narayan et al [4] reported an increased mortality with Hba1c >6.5% on a univariate analysis, which was eventually not statistically significant after a multivariate analysis. A multicenter study by Kuhl et al [14] also reported an increasing in 30-day and long-term mortality associated with increasing preoperative Hba1c levels.…”

“…HbA1c is more reliable than a spot glucose test as a marker of diabetic control, since the latter is associated with more variability. Data on association of preoperative glycemic control with post-CABG outcomes have been conflicting, with studies conducted in populations with inconsistent demographic characteristics [2][3][4]. Therefore, we conducted a study in a patient population of the Genesee County of Michigan (MI) with a total population of 407,385 persons [5].…”

Intensity of Glycemic Control Affects Long-Term Survival After Coronary Artery Bypass Graft Surgery

“…A 2008 study from Emory compared patients with HbA 1c greater or less than 6.5%. Patients with HbA 1c greater than 6.5% had no in-hospital death difference but did have more respiratory complications and sternal dehiscence [9]. This was one of the first studies on this topic and provided the groundwork for many others.…”

Is the era of bilateral internal thoracic artery grafting coming for diabetic patients? An updated meta-analysis

“…associated with a significant increase in the incidence of DSWI. 39,40 In the present meta-analysis, 2 studies 8,27 recorded the data of HgbA1c before operation (Kinoshita and colleagues 8 : 6.1% AE 2.1% for SITA vs 6.3% AE 2.4% for BITA; Agrifoglio and colleagues 27 : 8.3% AE 0.9% for SITA vs 8.6% AE 1.0% for BITA). In addition, intensive glucose control was associated with a reduction of DSWI and mortality after CABG, as previously reported by Furnary and associates.…”