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Published on: June 28, 2019
Relationship between preoperative hemoglobin A1c and late postoperative coronary flow reserve improvement after
Takahiro Fujimoto1, Kentaro Honda2, Hideki Kunimoto2
1Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8509, Japan. taka46.fuji@gmail.com.
Insights
Preoperative hemoglobin A1c levels predict coronary flow reserve improvement after coronary artery bypass grafting. Lower A1c levels correlate with better long-term outcomes in patients with diabetes mellitus.
Area of Science:
- Cardiology
- Diabetology
- Vascular Surgery
Background:
- Coronary artery bypass grafting (CABG) is a critical intervention for coronary artery disease.
- Diabetes mellitus is a significant comorbidity affecting CABG outcomes.
- Hemoglobin A1c (HbA1c) reflects long-term glycemic control.
Purpose of the Study:
- To investigate the association between preoperative HbA1c concentration and late improvement in coronary flow reserve (CFR) post-CABG.
- To determine if preoperative glycemic control influences myocardial perfusion recovery after revascularization.
Main Methods:
- Retrospective analysis of 61 patients undergoing isolated CABG.
- Measurement of CFR preoperatively, early postoperatively (2.5 months), and late postoperatively (25 months).
- Classification of patients based on preoperative HbA1c (<7% vs. ≥7%) and diabetes duration (<10 years vs. ≥10 years).
Main Results:
- No significant difference in early CFR between HbA1c groups.
- Significantly greater late CFR improvement in patients with HbA1c <7% compared to those with HbA1c ≥7% (p=0.012).
- Lower preoperative HbA1c correlated with greater late CFR improvement (R²=0.13, p=0.019); longer diabetes duration and higher HbA1c were linked to poorer CFR improvement.
Conclusions:
- Preoperative HbA1c concentration is a significant predictor of late CFR improvement after CABG.
- Optimizing glycemic control before CABG may enhance long-term myocardial functional recovery in diabetic patients.
Objective:
This study was performed to investigate the relationship between the preoperative hemoglobin A1c concentration and late postoperative coronary flow reserve improvement after coronary artery bypass grafting.
Methods:
The data of 61 patients who underwent isolated coronary artery bypass grafting were retrospectively analyzed. Coronary flow reserve was measured preoperatively, in the early postoperative period (mean: 2.5 months), and in the late postoperative period (mean: 25 months). The patients were classified into two groups based on their preoperative hemoglobin A1c concentration: Group N (< 7%) and Group D (≥ 7%). Further classification was based on the duration of diabetes mellitus (< 10 years or ≥ 10 years).
Results:
There was no significant difference in early postoperative coronary flow reserve between the two groups. However, in the late postoperative period, Group N exhibited significantly greater coronary flow reserve improvement than Group D (p = 0.012). There was a significant correlation between a lower preoperative hemoglobin A1c concentration and greater late postoperative coronary flow reserve improvement (R2 = 0.13, p = 0.019). Patients with a longer history of diabetes mellitus and a higher preoperative hemoglobin A1c concentration had poorer coronary flow reserve improvement in the late postoperative period.
Conclusions:
The preoperative hemoglobin A1c concentration predicted coronary flow reserve improvement in the late postoperative period after coronary artery bypass grafting.
