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Atrial fibrillation - Can HbA1c levels really predict the risk?

Pradeep Narayan1, Chandan Kumar Mandal2, Rajlakshmi Das2

  • 1Department of Cardiac Surgery, NH Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.

Asian Cardiovascular & Thoracic Annals
|March 3, 2021
PubMed
Summary

Glycated hemoglobin (HbA1c) levels do not independently predict atrial fibrillation after coronary artery bypass grafting. This study found no significant association between HbA1c and post-operative atrial fibrillation risk.

Keywords:
HbA1catrial fibrillationcoronary artery bypass grafting

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Area of Science:

  • Cardiology
  • Diabetology
  • Surgical Outcomes

Background:

  • Diabetes mellitus is linked to worse outcomes after coronary artery bypass grafting (CABG).
  • Glycated hemoglobin (HbA1c) is associated with adverse post-operative outcomes.
  • The specific role of HbA1c in predicting post-CABG atrial fibrillation (AF) remains unclear.

Purpose of the Study:

  • To investigate the association between HbA1c levels and the incidence of post-operative atrial fibrillation.
  • To determine if HbA1c is an independent predictor of AF after off-pump coronary artery bypass grafting (OPCABG).

Main Methods:

  • Retrospective analysis of data from patients undergoing OPCABG.
  • Patients were stratified into two groups based on HbA1c levels (<6.5% and ≥6.5%).
  • Comparison of AF incidence between groups and identification of independent risk factors for post-operative AF.

Main Results:

  • A total of 5259 patients were analyzed; 11.8% developed post-operative AF.
  • Multivariate analysis indicated that HbA1c was not an independent risk factor for AF (OR 1.144).
  • Independent predictors of AF included increased age, higher EuroSCORE, peripheral vascular disease, and recent myocardial infarction.

Conclusions:

  • Glycated hemoglobin levels do not independently predict the risk of atrial fibrillation following OPCABG.
  • Factors such as age, EuroSCORE, and comorbidities are more significant predictors of post-operative AF.