Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Measurement of HbA1c
2.3. Diabetes Mellitus Status
2.4. Study Outcomes
2.5. Post-Operative Glycemic Control
2.6. Statistical Analysis
3. Results
3.1. Population
3.2. Clinical Outcomes
Early Outcomes
3.3. Late Outcomes
3.4. Post-Operative Glycemic Control
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Number Exposed to Risk | |||||||||||
HbA1c ≤ 7 | 198 | 196 | 189 | 181 | 172 | 166 | 159 | 153 | 150 | 146 | 76 |
HbA1c > 7 | 362 | 355 | 336 | 318 | 299 | 282 | 267 | 251 | 240 | 229 | 116 |
Years | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Characteristics | HbA1c ≤ 7% | HbA1c > 7% | p Value |
---|---|---|---|
n = 206 | n = 373 | ||
Age Mean ± SD | 67 ± 9 | 63 ± 9 | <0.001 |
Male | 159 (77.2) | 268 (71.2) | 0.16 |
HTN | 144 (69.9) | 258 (69.2) | 0.85 |
CHF | 9 (4.4) | 16 (4.3) | 0.96 |
CRF | 11 (5.3) | 17 (4.6) | 0.67 |
COPD | 8 (3.9) | 25 (6.7) | 0.16 |
History of MI | 56 (27.2) | 88 (23.6) | 0.34 |
Smoking | 63 (30.6) | 135 (36.2) | 0.17 |
Characteristics | HbA1c ≤ 7% | HbA1c > 7% | All | p Value |
---|---|---|---|---|
n = 206 | n = 373 | |||
MACCE | 15 (7.3) | 18 (4.8) | 33 (5.7) | 0.22 |
Mortality | 8 (3.9) | 11 (2.9) | 19 (3.3) | 0.55 |
PCI | 0 (0) | 0 (0) | 0 (0) | --- |
Stroke | 2 (1.0) | 2 (0.5) | 4 (0.7) | 0.56 |
AMI | 6 (2.9) | 7 (1.9) | 13 (2.2) | 0.42 |
STEMI | 1 (0.5) | 2 (0.5) | 3 (0.5) | 0.94 |
NSTEMI | 6 (2.9) | 6 (1.6) | 12 (2.1) | 0.29 |
Atrial fibrillation | 36 (17.5) | 38 (10.2) | 74 (12.8) | 0.01 |
Wound infections | 11 (5.3) | 30 (8.0) | 41 (7.1) | 0.23 |
Acute renal failure | 28 (13.6) | 41 (11.0) | 69 (11.9) | 0.35 |
Cardiogenic shock | 1 (0.5) | 5 (1.3) | 6 (1.0) | 0.33 |
Re-surgery due to post-operative bleeding | 7 (3.4) | 11 (2.9) | 18 (3.1) | 0.76 |
Pneumonia | 4 (1.9) | 10 (2.7) | 14 (2.4) | 0.58 |
ACS | 7 (3.4) | 8 (2.1) | 15 (2.6) | 0.36 |
Median length of stay (IQR) | 6 (4; 8) | 6 (4; 8) | 6 (4; 8) | 0.58 |
Characteristics | HbA1c ≤ 7% | HbA1c > 7% | All | p Value |
---|---|---|---|---|
n = 206 | n = 373 | |||
MACCE | 71 (34.5) | 155 (41.6) | 226 (39.0) | 0.04 |
Mortality | 42 (20.4) | 107 (28.7) | 149 (25.7) | 0.01 |
AMI | 26 (12.6) | 46 (12.3) | 72 (12.4) | 0.76 |
-STEMI ^ | 2 (1.0) | 3 (0.8) | 5 (0.9) | 0.09 |
-NSTEMI ^ | 25 (12.1) | 44 (11.8) | 69 (11.9) | 0.78 |
PCI | 24 (11.7) | 40 (10.7) | 64 (11.1) | 0.97 |
Stroke | 10 (4.9) | 29 (7.8) | 39 (6.7) | 0.13 |
CHF hospitalization | 4 (1.9) | 6 (1.6) | 10 (1.7) | 0.89 |
Glycemic control by HbA1c% Median (IQR) | 6.5 (6.1; 7.1) | 8.1 (7.3; 9.2) | 7.5 (6.6; 8.5) | <0.001 |
Characteristics | Hazard Ratio | p Value | 95% Confidence Interval | |
---|---|---|---|---|
Lower | Upper | |||
Age (Years) | 1.04 | 0.01 | 1.01 | 1.06 |
Old MI | 1.87 | 0.01 | 1.19 | 2.92 |
History of CHF | 2.20 | 0.06 | 0.96 | 4.93 |
CRF | 4.49 | <0.001 | 2.11 | 9.54 |
COPD | 2.60 | 0.01 | 1.28 | 5.28 |
HbA1c > 7% | 2.67 | 0.001 | 1.52 | 4.68 |
Glycemic control | 1.003 | 0.97 | 0.86 | 1.18 |
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Abu Tailakh, M.; Ishay, S.-y.; Awesat, J.; Poupko, L.; Sahar, G.; Novack, V. Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery. J. Clin. Med. 2021, 10, 2739. https://doi.org/10.3390/jcm10122739
Abu Tailakh M, Ishay S-y, Awesat J, Poupko L, Sahar G, Novack V. Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery. Journal of Clinical Medicine. 2021; 10(12):2739. https://doi.org/10.3390/jcm10122739
Chicago/Turabian StyleAbu Tailakh, Muhammad, Shlomo-yaron Ishay, Jenan Awesat, Liat Poupko, Gidon Sahar, and Victor Novack. 2021. "Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery" Journal of Clinical Medicine 10, no. 12: 2739. https://doi.org/10.3390/jcm10122739