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September 10, 2013Interactive Cardiovascular and Thoracic SurgeryOpen Access

Is there a role for HbA1c in predicting mortality and morbidity outcomes after coronary artery bypass graft surgery?: Table 1:

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Key result

Elevated preoperative HbA1c is a strong predictor of mortality and morbidity after CABG irrespective of previous diabetic status, with mortality risk quadrupled at HbA1c levels >8.6%.

Why the study?

Does elevated preoperative HbA1c predict mortality and morbidity outcomes in patients undergoing coronary artery bypass graft surgery?

Population

Patients undergoing coronary artery bypass graft surgery, including diabetic, non-diabetic, or mixed patient…

Comparison

Elevated preoperative HbA1c levels vs Normal or well-controlled preoperative HbA1c…

Design

Systematic_review

Authors

CTCharlene TennysonUniversity of WashingtonRLRebecca LeeGeological Survey of CanadaRARizwan AttiaMinneapolis Heart Institute Foundation

Discussion

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Implication

Preoperative HbA1c may refine CABG risk stratification irrespective of diabetes status; leaves open whether optimization improves outcomes.

Study Design

Type

Systematic Review

Structured PICO

Does elevated preoperative HbA1c predict mortality and morbidity outcomes in patients undergoing coronary artery bypass graft surgery?

P
Population
Eleven studies evaluating the relationship between preoperative HbA1c levels and postoperative outcomes following coronary artery bypass graft surgery.
E
Exposure
Elevated preoperative HbA1c levels
C
Comparator
Normal or well-controlled preoperative HbA1c levels
O
Outcome
Mortality and morbidity outcomes after coronary artery bypass surgeryhard clinical

Main Result

Odds Ratio: 1.53 (95% CI 1.24–1.91)

p-value: p=0.0005

Elevated preoperative HbA1c is a strong predictor of increased mortality and morbidity following CABG, regardless of a prior diabetes diagnosis.

Limitations

  • Long-term outcomes in well-controlled diabetics have not been reported.
  • Long-term outcomes in well-controlled diabetics have not been reported

Cite This Study

Tennyson et al. (2013) conducted a systematic review in Coronary artery bypass graft surgery. Elevated preoperative HbA1c vs. Normal or well-controlled HbA1c was evaluated on 30-day survival (in patients with previously undiagnosed diabetes and HbA1c >6%) (OR 1.53, 95% CI 1.24-1.91, p=0.0005). Elevated preoperative HbA1c is a strong predictor of mortality and morbidity after CABG irrespective of previous diabetic status, with mortality risk quadrupled at HbA1c levels >8.6%.

synapsesocial.com/papers/6a5f3f0f531077db68af41ddhttps://doi.org/10.1093/icvts/ivt351

Topics

Coronary artery disease
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hyperglycemia or High Hemoglobin A1C: Which One is More Associated with Morbidity and Mortality after Coronary Artery Bypass Graft Surgery?2013 · 38 citations
  2. 2Preoperative hemoglobin A1c predicts atrial fibrillation after off-pump coronary bypass surgery2011 · 61 citations
  3. 3Towards evidence-based medicine in cardiothoracic surgery: best BETS2003 · 677 citations
  4. 4Prevalence of Dysglycemia Among Coronary Artery Bypass Surgery Patients with No Previous Diabetic History2011 · 48 citations