Hemoglobin a1c in patients with diabetes predict long-term mortality following coronary artery surgery

Muhammad Abu Tailakh, Shlomo Yaron Ishay, Jenan Awesat, Liat Poupko, Gidon Sahar, Victor Novack

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 ± 1.7%, where 206 (35.6%) patients had an HbA1c ≤ 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c ≤ 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.

Original languageEnglish
Article number2739
JournalJournal of Clinical Medicine
Volume10
Issue number12
DOIs
StatePublished - 1 Jun 2021

Keywords

  • Coronary artery bypass grafting
  • Diabetes mellitus
  • Hemoglobin A1c
  • Mortality

ASJC Scopus subject areas

  • Medicine (all)

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