The prevalence of elevated hemoglobin A1c in patients undergoing coronary artery bypass surgery

被引:19
作者
Engoren, Milo [1 ]
Habib, Robert H. [1 ]
Zacharias, Anoar [1 ]
Schwann, Thomas A. [1 ]
Riordan, Christopher J. [1 ]
Durham, Samuel J. [1 ]
Shah, Aamir [1 ]
机构
[1] Univ Toledo Hlth Sci Campus, Dept Anesthesiol, St Vincent Mercy Med Ctr, Toledo, OH 43608 USA
关键词
D O I
10.1186/1749-8090-3-63
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Diabetes mellitus has become a major health issue in the United States and contributes to morbidity and mortality from coronary artery disease. Despite lifestyle changes and medications that have been shown to decrease complications and death, many persons have poor glycemic control. The purpose of this study is to determine the prevalence of elevated Hemoglobin A1c levels, a marker of glycemic control in patients presenting for coronary artery bypass surgery, and to determine if risk factors for diabetes mellitus could identify those patients with an elevated hemoglobin A1c. Methods: All patients undergoing coronary artery bypass surgery had hemoglobin A1c levels determined immediately preoperatively. Proportions were used to describe the number of patients with elevated levels. Linear regression and receiver operator characteristic curves were used to evaluate the accuracy of risk factors to identify patients with elevated levels. Results: 83 of 87 (95%) diabetic patients had elevated A1c levels (>= 6.0%), with 55 of 87 (63%) having inadequate control - A1c levels >= 7.0. 93 of 163 (57%) non-diabetic patients had elevated A1c levels (>= 6.0%), with 19 (12%) having levels >= 7.0%. Risk factors for diabetes mellitus poorly predicted which patient had elevated A1c levels. Conclusion: The prevalence of elevated hemoglobin levels in patients undergoing coronary artery bypass surgery is high and routine measurement should be done to permit institution of lifestyle modifications and medication changes that decrease complications and death from diabetes mellitus.
引用
收藏
页数:5
相关论文
共 19 条
[1]  
*AM COLL END, 2002, ENDOCR PRACT S1, V8, P5
[2]  
American Diabetes Association, 2007, Diabetes Care, V30 Suppl 1, pS42
[3]  
[Anonymous], 2007, DIABETES CARE, DOI DOI 10.2337/DC07-S004
[4]  
[Anonymous], 2005, National diabetes fact sheet
[5]   Developments in diabetes and insulin resistance [J].
Bloomgarden, ZT .
DIABETES CARE, 2006, 29 (01) :161-167
[6]   Multidisciplinary intervention for control of diabetes in patients undergoing coronary artery bypass graft (CABG) [J].
Cohen, O ;
Dankner, R ;
Chetrit, A ;
Luxenburg, O ;
Langenauer, C ;
Shinfeld, A ;
Smolinsky, AK .
CARDIOVASCULAR SURGERY, 2003, 11 (03) :195-200
[7]   Relation of hemoglobin A1c to rate of major adverse cardiac events in nondiabetic patients undergoing percutaneous coronary revascularization [J].
Corpus, RA ;
O'Neill, WW ;
Dixon, SR ;
Timmis, GC ;
Devlin, WH .
AMERICAN JOURNAL OF CARDIOLOGY, 2003, 92 (11) :1282-1286
[8]   Disturbances of glucose metabolism in men referred for coronary arteriography -: Postload glycemia as a predictor for coronary atherosclerosis [J].
Kowalska, I ;
Prokop, J ;
Bachórzewska-Gajewska, H ;
Telejko, B ;
Kinalskal, I ;
Kochman, W ;
Musial, W .
DIABETES CARE, 2001, 24 (05) :897-901
[9]  
MOKDAD AH, 2001, JAMA-J AM MED ASSOC, V289, P76, DOI DOI 10.1001/JAMA.289.1.76
[10]   Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes [J].
Nathan, DM ;
Cleary, PA ;
Backlund, JYC ;
Genuth, SM ;
Lachin, JM ;
Orchard, TJ ;
Raskin, P ;
Zinman, B .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (25) :2643-2653