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

Objectives: Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA۱c 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 ۳۰۰ diabetic patients including ۱۸۶ (۶۲%) men and ۱۱۴ (۳۸%) women who underwent CABG from March ۲۰۱۰ to August ۲۰۱۱ and selected via census method. Preoperative blood glucose control status was determined using HbA۱c levels, and the patients were evaluated for postoperative in-hospital complications.Results: The mean age of the patients was ۶۲.۳ ± ۶.۹ years. In-hospital mortality was ۱.۰% (۳/۳۰۰). New-onset atrial fibrillation was the most common complication (۳۵%). HbA۱c level above ۷.۵% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio ۱.۹, ۹۵٪ CI: ۱.۱-۳.۲, p = ۰.۰۰۶). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA۱c level in two groups with or without complication.Conclusions: Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA۱c measurement can be a predictor of high-risk patients.

Keywords:

Diabetes mellitus , HbA۱c , CABG , Postoperative mortality , Glycemic control