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Relationship between Perioperative Cardiovascular Events and Glycated Hemoglobin in Diabetic Patients Undergoing

Zhengwen Chen1, Shuncai Ding1, Yingchuan Yuan1

  • 1Department of Anesthesia, The Second Affiliated Hospital to Xinjiang Medical University, Urumqi 830000, China.

Biomed Research International
|December 31, 2020
PubMed

Insights

Elevated hemoglobin A1c (HbA1c) levels in diabetic patients undergoing noncardiac surgery are linked to increased perioperative cardiovascular events (PCE). Managing blood sugar is crucial for reducing surgical risks.

Area of Science:

  • Cardiology
  • Endocrinology
  • Surgical Outcomes

Background:

  • Diabetes mellitus is a significant risk factor for cardiovascular disease.
  • Perioperative cardiovascular events (PCE) are a major concern in diabetic patients undergoing noncardiac surgery.
  • Glycemic control, indicated by HbA1c, may influence surgical outcomes.

Purpose of the Study:

  • To investigate the association between hemoglobin A1c (HbA1c) levels and perioperative cardiovascular events (PCE).
  • To analyze PCE risk in diabetic patients undergoing complex or moderately complex noncardiac surgery based on HbA1c stratification.
  • To identify independent predictors of PCE in this patient population.

Main Methods:

  • Retrospective nested case-control study design.
  • Inclusion of 318 diabetic patients who underwent noncardiac surgery between 2013-2018.
  • Categorization of patients into four HbA1c groups: ≤7%, 7.1%-7.9%, 8.0%-8.9%, and ≥9% for analysis.

Main Results:

  • The overall occurrence rate of PCE was 28.3% among the 318 patients.
  • Higher HbA1c levels (≥8.0%) were associated with significantly increased PCE rates compared to the 7.1%-7.9% group (P < 0.001).
  • Multivariable analysis identified diabetes duration (HbA1c stratification), HbA1c level, systolic blood pressure (SBP), and microalbuminuria as independent predictors of PCE.

Conclusions:

  • Hemoglobin A1c levels are significantly associated with the incidence of perioperative cardiovascular events in diabetic patients undergoing noncardiac surgery.
  • Glycemic control is a critical factor in mitigating cardiovascular risks during the perioperative period for diabetic patients.
  • The findings underscore the importance of optimizing HbA1c levels to improve surgical outcomes and reduce PCE in diabetic patients.

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