Key result
Each unit HbA1c increase in poorly controlled diabetic CABG patients links to ~25% higher reintervention risk.
Why the study?
To evaluate the gender-specific effects of high HbA1c levels on long-term morbidity, mortality, and re-revascularization in poorly controlled diabetic patients undergoing isolated CABG.
Does a high preoperative HbA1c level (>7%) increase long-term morbidity, mortality, and the need for re-revascularization in male and female diabetic patients undergoing isolated CABG?
Cohort (n=532)
No
Does a high preoperative HbA1c level (>7%) increase long-term morbidity, mortality, and the need for re-revascularization in male and female diabetic patients undergoing isolated CABG?
Effect estimate: OR 1.249 (95% CI 1.055-1.478)
p-value: p=0.010
In diabetic patients undergoing isolated CABG, preoperative HbA1c >7% is associated with an increased long-term need for repeat revascularization, but does not significantly impact long-term mortality compared to HbA1c ≤7%.
Objective: The aim of this study is to evaluate the gender specific effects of the high HbA1c levels in poorly controlled diabetic patients undergoing isolated coronary artery bypass grafting (CABG) procedure on long term morbidity, mortality and re-revascularization (2nd intervention). Methods: This study was conducted on 532 (346 (65%) males and 186 (35%) females) diabetic patients who underwent CABG procedure at a single center between January 2010 and December 2013.The patients were separated into 4 groups according to gender and preoperative HbA1c level (%). The group1 consisted of females with HBA1c level ≤7(n=46); the group 2 comprised female with HbA1c level >7(n=140); the group 3 comprised men with HbA1c level ≤7(n=117); and the group 4 comprised men with HbA1c level >7(n=229). The groups were analyzed and compared for postoperative complications and mortality. Results: No statistically significant difference was found among the groups in HbA1c levels and gender with respect to postoperative infection and mortality (p>0.05). The HbA1c level was determined to be statically significant and required the 2ndintervention (p:0.001; 95% CI: 1.249 (1.055,1.478)). Conclusion: This study suggested that there was no difference in mortality rates after CABG among the groups although the current risk calculator modules stated otherwise. However, the HbA1c levels were associated with a need for a secondary intervention on long term follow up period.
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Aksoy et al. (2021) conducted a cohort in Poorly controlled diabetes undergoing isolated coronary artery bypass grafting (CABG) (n=532). Higher HbA1c level vs. Lower HbA1c level was evaluated on Need for 2nd intervention (re-revascularization) (OR 1.249, 95% CI 1.055-1.478, p=0.010). A one-unit increase in HbA1c levels in poorly controlled diabetic patients undergoing CABG was associated with a 1.249 times higher risk of requiring a secondary intervention, with no effect on mortality.
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