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Analysis of Preoperative Hba1c Levels as Outcome Predictor after off Pump Coronary Artery Bypass Graft Surgery

Associate Professor, Cardiac surgery, Sri Jayadeva Institute of Cardiovascular sciences & Research, Bangalore, Karnataka 560069, India. , Govindaiah Satish , Pangi Manish , Lakshman Sudheer ,

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Journal of Cardiovascular Medicine and Surgery 4(3):p 231-236, Jul-Sep 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4318.7

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Abstract

Context: Diabetes Mellitus is a proven risk factor for adverse events for coronary artery disease and its prevalence among patients continues to rise. Hemoglobin A1c (HbA1c) is an accepted marker for adequacy of glycemic control. But it is not known whether it could be used to predict outcome after off pump coronary artery bypass graft (OPCAB) surgery. Aims: To study adequacy of using baseline HbA1c levels to predict outcome after coronary artery bypass graft especially in OPCAB surgery. Settings and Design: Retrospective observational study. Methods and Material: Diabetic patients undergoing isolated OPCAB surgery from 2015 to 2018, done by a single surgical team in a tertiary care institution, were included. The cohort of 310 patients was then grouped into three groups depending upon their HbA1c levels. The patient data, operative factors and 30 day post operative outcomes were compared. Statistical analysis used: variables were compared using student’s t test and paired t test. A p value <0.05 was considered significant. Results: Of the 310 patients, there were no significant differences in the baseline and angiographic characteristics. Mortality was observed in 2 patients in group I, 3 in Group II and 4 in group
III corresponding to 3% among the groups, hence not significant. The only significant differences in morbidity were found to be higher superficial surgical site infection (p value 0.0039) and duration of post operative stay (p value 0.0032) in group III patients. Conclusions: Preoperative baseline HbA1c levels can be used to predict minor morbidity but are not suitable for predicting mortality in OPCAB surgery.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4318.7

Keywords

HbA1c; Outcome; Coronary Revascularisation; Opcab.

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