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Elevated glycosylated haemoglobin (HbA1c) is a risk marker in coronary artery bypass surgery

Thomas Alserius1, Russell E Anderson, Niklas Hammar

  • 1Department of Cardiothoracic Surgery and Anaesthesiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.

Scandinavian Cardiovascular Journal : SCJ
|July 9, 2008
PubMed

Insights

Elevated glycosylated haemoglobin (HbA1c) levels, even in non-diabetic patients, significantly increase the risk of superficial sternal wound infections and long-term mortality following coronary artery bypass grafting (CABG) surgery.

Area of Science:

  • Cardiovascular Surgery
  • Endocrinology
  • Infectious Disease

Background:

  • Glycosylated haemoglobin (HbA1c) reflects long-term glycemic control.
  • Optimal glycemic targets in patients undergoing coronary artery bypass grafting (CABG) are crucial for postoperative outcomes.

Purpose of the Study:

  • To investigate the association between preoperative glycosylated haemoglobin (HbA1c) levels and the risk of infection and mortality after CABG.
  • To determine if HbA1c is a predictor of adverse outcomes irrespective of diabetes mellitus (DM) diagnosis.

Main Methods:

  • Prospective observational study design.
  • Preoperative HbA1c concentrations were measured in patients undergoing CABG.
  • Patients were followed for an average of 3.5 years to assess infection and mortality rates.

Main Results:

  • A significant increase in superficial sternal wound infections was observed in patients with HbA1c ≥6% (13.9%) compared to those with HbA1c <6% (5.5%).
  • Patients with HbA1c ≥6% experienced significantly higher follow-up mortality (18.9%) versus those with HbA1c <6% (4.1%).
  • The elevated risk of death was comparable between diabetic and non-diabetic patients with HbA1c ≥6%.

Conclusions:

  • Preoperative HbA1c levels ≥6% are associated with an increased risk of superficial sternal wound infections post-CABG.
  • Higher HbA1c levels correlate with a significantly increased risk of mortality within three years of CABG.
  • Glycemic control, indicated by HbA1c, is a critical factor influencing outcomes after CABG, regardless of a formal DM diagnosis.
Abstract

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