Relationship Between Elevated HbA1c and Deep Sternal Wound Infection in Patients Undergoing Cardiac Surgery

Sevük, Utkan; Bilgiç, Abdulkadir; Yaylak, Barış; Ay, Nurettin; Baysal, Erkan; Altındağ, Rojhat; Alp, Vahhaç; Beyazıt, Ünal; Akkaya, Süleyman; Erkul, Aylin

doi:10.5578/khj.10344

Cited by 3 publications

(6 citation statements)

References 27 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…KLF4 has been reported to physically bind to the active subunit P65 of transcription factor NF-κB in vascular endothelial cells to prevent the nuclear translocation of P65, thereby exerting its anti-inflammatory role by inhibiting the transcriptional activation on downstream inflammatory factors of P65 [ 22 ] . In endothelial cells and immune cells, P300 can bind with the active subunit P65 of NF-κB to induce acetylation of P65, thereby promoting the transcriptional activation on downstream inflammatory factors by P65 [ 23 ] . Overexpressed KLF4 can competitively bind to P300, inhibiting the binding of P300 with P65 to attenuate its transcriptional activity, subsequently exerting an anti-inflammatory effect [ 23 ] .…”

Section: Discussionmentioning

confidence: 99%

Long Noncoding RNA AF131217.1 Regulated Coronary Slow Flow-Induced Inflammation Affecting Coronary Slow Flow via KLF4

Jiang

Zhang

et al. 2022

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

Introduction This study investigated the correlation between the levels of long noncoding ribonucleic acids (lncRNAs) AF131217.1 and coronary slow flow (CSF). Methods A total of 22 patients in the high-sensitivity C-reactive protein (hsCRP) group diagnosed with CSF from January 2018 to December 2018 were enrolled in this study. Coronary flow velocity was determined using the thrombolysis in myocardial infarction frame count (TFC) method. Results: LncRNA AF131217.1 expression in the CSF model was activated. Mean TFC was positively correlated with lncRNA AF131217.1 levels and hsCRP levels. LncRNA AF131217.1 induced inflammation factor levels in the in vitro model. Micro ribonucleic acid (miR)-128-3p is a target spot of lncRNA AF131217.1 on the inflammation in vitro model via Kruppel-like factor (KLF) 4. MiR-128-3p reduced inflammation factor levels (tumor necrosis factor alpha, interleukin [IL]-6, IL-1β, and IL-18). Conclusion : Thus, lncRNA AF131217.1 promoted inflammation in the regulated CSF via KLF4 by miR-128-3p.

show abstract

Section: Discussionmentioning

confidence: 99%

Long Noncoding RNA AF131217.1 Regulated Coronary Slow Flow-Induced Inflammation Affecting Coronary Slow Flow via KLF4

Jiang

Zhang

et al. 2022

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…In the literature, there are some reports that investigated the development of DSSI in patients undergoing open-heart surgery [ 11 , 23 ] . Sevük et al [ 23 ] stated that there was no relationship between high perioperative HbA1c and DSSI, and that there was no increase in the frequency of DSSI development in patients with adequate perioperative glycemic control. Similarly, Kuhl et al [ 17 ] reported that they found no relationship between HbA1c level in perioperative mortality and DSSI development.…”

Section: Discussionmentioning

confidence: 99%

The Importance of HbA1c and Left Ventricular Ejection Fraction in Predicting the Development of Postoperative Mortality and Complications in Coronary Artery Bypass Graft Surgery

Özmen¹,

Tunçay²,

Yilmaz³

et al. 2022

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

Introduction In this study, we aimed to investigate the relationship between postoperative mortality, morbidity, hospital stay and development of postoperative complications with the glycosylated hemoglobin (HbA1c) level and low left ventricular ejection fraction (LVEF) in diabetic and non-diabetic patients who underwent elective coronary artery bypass (CABG) surgery. Methods The medical records of patients who underwent CABG at our clinic between January 2015 and December 2019 were retrospectively analyzed. All patients were divided into two groups according to their diabetes mellitus (DM) diagnosis. Diabetic patients were also divided into two groups according to their HbA1c levels. The HbA1c threshold value was 7%. All patients were divided into two groups in terms of LVEF. The LVEF threshold value was 40%. Results We analyzed 393 patients, of which 304 (77.4%) were male and 177 (45.04%) patients were diabetic. For lower LVEF and HbA1c values, we found no relationship between postoperative mortality, prolonged intensive care unit (ICU) stay and development of postoperative complications. Deep surgical site infection (DSSI) was found to be more common in diabetic patients who had a higher HbA1c value. Length of hospital stay was longer in diabetic patients with HbA1c levels <7%. Conclusion No statistically significant relationship was found between LVEF and HbA1c levels and postoperative mortality, prolonged ICU stay and postoperative complications.

show abstract

“…On contrast, other studies suggested that there is no strong relationship between elevated HbA1c% and SSI after CABG such as study carried out by Hudson and associateswhoexamined 1.474 patients found no association between elevated HbA1c and infection after cardiac surgery. However they found that Thirty-day mortality and acute kidney injury were significantly higher in patients with HbA1c>6% [16] Sevükand colleagesindicated that elevated HbA1c levels in the preoperative period is not a risk factor for DSWI in patients undergoing CABG while good perioperative glycemic control decreases incidence of DSWI [3] . In Offpump coronary artery bypass(OPCAB) patients with poorly controlled DM (HbA1c > 6.5) SSI was not related to elevated HbA1c levels as reported by Matsuura and cowrkers [16] .…”

Section: Discussionmentioning

confidence: 99%

“…The glycosylated hemoglobin (HbA1c %) is a sensitive and reliable biomarker that provides a measure of glucose control status over the prior 2-3 months. TheADA (American Diabetes Association) suggests an HbA1c goal of less than 7% to reduce long-term complications of DM [3] . Superficial wound infection (SWI) involves only the skin or subcutaneous tissue [4] .Deep Sternal Wound Infection (DSWI) involves the muscle, bone, pericardium, and/or mediastinum.…”

Section: Introductionmentioning

confidence: 99%

“…Superficial wound infection (SWI) involves only the skin or subcutaneous tissue [4] .Deep Sternal Wound Infection (DSWI) involves the muscle, bone, pericardium, and/or mediastinum. Additional conditions of DSWI may include purulent mediastinal drainage, positive cultures of mediastinalfluid or tissues,sternal instability or dehiscence, evidence of mediastinitis during surgery, abnormal sternotomy pain and fever > 38°C [3] . DSWI have a significantimpact on both patient prognosis and hospital budgets.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The relationship between elevated HbA1c% and surgical site infection in patients undergoing CABG

2018

Zagazig University Medical Journal

View full text Add to dashboard Cite

Objective: Controversy still exists whether adequacy ofpreoperative diabetes control measured by HbA1c% is a predictor of elevated incidence of surgical site infection (SSI) after CABG. Methods:prospective study was done on 48 diabetic patients underwent CABG surgery. They were classified into 2 groups, Group (A):24 patients with fair glycemic control (HbA1c isunder or equal to 7%), Group (B): 24 patients with poor glycemic control (HbA1c above 7%). SSI either sternotomy or saphenous wound infection were studied in both groups. Results: Superficial wound infection for group A was 12.5% and 25% for group B with significant statistical differenceamong the two groups. Deep Sternal Wound Infection (DSWI) was (4.1%) group A and group B with no statistical significance.As regard Saphenous wound infection was (8.3%) for groupA and (25%) for group B with statistical difference, also group B has higher frequency of hospital readmission and need inotropes more than groupA. Conclusions: Elevated HbA1c >7 in patients undergoing CABG associated with increasedfrequency of SWI and saphenous harvesting site infection but there was no significant increase in DSWI.Patients with elevated HbA1c >7 has more resistant peri-operative control of RBS. Finally we found that good peri-operative control of RBS associated with decreased rate of SSI after CABG. HbA1c is simple test that may offer the surgeon with better risk profile assessment and give additional prognostic data when discussing morbidity and mortality risks with patients and their relatives.

show abstract

Relationship Between Elevated HbA1c and Deep Sternal Wound Infection in Patients Undergoing Cardiac Surgery

Cited by 3 publications

References 27 publications

Long Noncoding RNA AF131217.1 Regulated Coronary Slow Flow-Induced Inflammation Affecting Coronary Slow Flow via KLF4

Long Noncoding RNA AF131217.1 Regulated Coronary Slow Flow-Induced Inflammation Affecting Coronary Slow Flow via KLF4

The Importance of HbA1c and Left Ventricular Ejection Fraction in Predicting the Development of Postoperative Mortality and Complications in Coronary Artery Bypass Graft Surgery

The relationship between elevated HbA1c% and surgical site infection in patients undergoing CABG

Contact Info

Product

Resources

About