The Association Between HbA1c Level and Complications of Bypass Surgery in Mazandaran Province in 2009

Background and purpose: Diabetes mellitus is associated with coronary artery disease, and diabetic patients are frequently referred for Coronary Artery Bypass Grafting (CABG). Plasma Haemoglobin A1c (HbA1c) shows mean blood glucose over a 3 months period. This study aimed to determine whether elevated plasma HbA1c levels were associated with increased postoperative morbidity and mortality in patients undergoing CABG. Materials and methods: Plasma HbA1c was measured prospectively in 135 consecutive patients undergoing emergency and elective CABG in the two cardiac surgery departments of Mazandaran Heart Center and Shafa Hospital in Sari, Iran from 11 April 2009 to 11 September 2009. All patients were under observation for 6 months after operation to assess the postoperative morbidity and mortality. Results: Of 135 studied patients (81 males and 56 females) who were admitted for emergency and elective CABG, 88 subjects (65.1%) were non-diabetic and 47 (34.9%) were diabetic patients. The mean age was 52 years ranged from 33 to 78 years. Suboptimal HbA1c levels were found in 48 (54.5%) patients without diabetes and in 24 (51%) patients with diabetes. Wound infection, low cardiac output state, need for Intra Aortic Balloon Pump, long hospital stay, and Cerebrovascular Accident were more common after CABG in non-diagnosed (suboptimal HbA1c) patients. No significant difference was found in terms of length of hospital stay between the two groups. Conclusion: It seems that the complications of CABG surgery is significantly higher in patients with high level of plasma HbA1c level and those patients whose blood sugar was controlled inappropriately.