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Journal of Cardiovascular Medicine and Surgery

Volume  1, Issue 1, January - June 2015, Pages 11-16
 

Original Article

Elevated Pre-Operative Hba1c Affects Outcome of Coronary Artery Bypass Grafting

Singh Sushil K., Gupta Santosh, Kaushal Dinesh, Tewarson Vivek

*Department of Cardiothoracic and Vascular surgery, King George’s Medical University, Lucknow, Uttar Pradesh- 226003 (India). **Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh- 226003 (India).

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Abstract

 Aims: The objective of the study was to identify the impact of elevated haemoglobin A1c (HbA1c) and related co-morbidities on morbidity and mortality of patients undergoing coronary artery bypass grafting. Settings and Design: This was a prospective study in which 126 patients that underwent isolated, elective, off pump CABG from October 2010 to October 2012. Methods and Material: 126 patients undergoing coronary artery bypass grafting (CABG) were enrolled and preoperative HbA1c levels were obtained. The Portland protocol for insulin was used to achieve tight glucose control. The multivariate risk factors for morbidity and mortality were analyzed. Statistical analysis used: Statistical analysis was performed with the SPSS software package (version 16.0, SPSS Inc, Chicago, IL). The normality of the continuous variables was tested by using Kolmogorov-Smirmov Z test. Tests used were unpaired t-test for continuous variables and chi square test for dichotomous/categorical variables. A p value less than .05 was taken as significant. Results:  In-hospital mortality was significantly higher for patients with HbA1c e” 7% and also the incidences of post-operative morbidities were significantly increased. These patients had more blood loss and received more blood products and had prolonged ventilatory time and spent more time in the hospital Conclusions: HbA1c may be a more accurate predictor of outcomes than merely a diagnosis of diabetes and is associated with adverse events after coronary artery bypass grafting. 

Keywords: Glycosylated Haemoglobin; Coronary Artery Bypass Grafting ; Off-Pump; Diabetes.
Key Messages: HbA1c is a powerful predictor of in-hospital death and morbidity. 

Corresponding Author : Singh Sushil K.