Key result
Preablation HbA1c ≥7.5% and upward trends are linked to higher 48-month AF recurrence.
Why the study?
The study was performed to assess the effect of preablation glycemic control on atrial fibrillation recurrence rates after heart valve surgery concomitant with Cox-Maze IV ablation.
Does preablation glycemic control reduce atrial fibrillation recurrence in patients with diabetes mellitus undergoing heart valve surgery combined with the Cox-Maze IV procedure?
Cohort
Does preablation glycemic control reduce atrial fibrillation recurrence in patients with diabetes mellitus undergoing heart valve surgery combined with the Cox-Maze IV procedure?
p-value: p=<0.001
Maintaining an HbA1c < 7.5% and a downward trend in the 12 months prior to surgery significantly reduces atrial fibrillation recurrence in diabetic patients undergoing concomitant valve surgery and Cox-Maze IV ablation.
May warrant preablation glycemic optimization; hypothesis-generating and requires prospective confirmation.
Background This study was performed to assess the effect of preablation glycemic control on atrial fibrillation recurrence rates after heart valve surgery concomitant with Cox-Maze IV ablation. Methods Twelve-month preablation trends in glycemic control were studied. Recurrence and clinical outcome data were obtained during a mean follow-up period of 36.7 ± 23.3 months postablation. Results Higher glycated hemoglobin (HbA1c) at the time of ablation was associated with higher postablation recurrence rates. The cumulative atrial fibrillation recurrence-free survival of patients with HbA1c ≥7.5% at the time of operation at 12, 24, 36 and 48 months was 97.1, 78.3, 54.2, and 36.3%, respectively (P < 0.001), and 100, 84.9, 37.2, and 16.2% for patients who preoperatively had an upward trend in HbA1c, respectively (P < 0.001). Conclusion Maintaining a downward trend in HbA1c during the 12-month period before the operation and an HbA1c value < 7.5% at the time of the operation reduced the recurrence of AF among patients who underwent heart valve surgery concomitant with the Cox-Maze IV procedure.
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Peng et al. (2022) conducted a cohort in Atrial Fibrillation with Diabetes Mellitus. Preablation glycemic control (HbA1c ≥7.5% or upward trend) vs. HbA1c <7.5% or downward trend was evaluated on Atrial fibrillation recurrence (p=<0.001). Preablation HbA1c ≥7.5% and an upward trend in HbA1c were associated with lower 48-month atrial fibrillation recurrence-free survival (36.3% and 16.2%, respectively; P<0.001).
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