Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery

被引:7
作者
Abu Tailakh, Muhammad [1 ,2 ]
Ishay, Shlomo-yaron [3 ,4 ]
Awesat, Jenan [4 ,5 ]
Poupko, Liat [4 ,6 ]
Sahar, Gidon [3 ,4 ]
Novack, Victor [4 ,5 ,7 ]
机构
[1] Ben Gurion Univ Negev, Recanati Sch Community Hlth Profess, Dept Nursing, Fac Hlth Sci, IL-8410501 Beer Sheva, Israel
[2] Soroka Univ Med Ctr, Nursing Res Unit, IL-84101 Beer Sheva, Israel
[3] Soroka Univ Med Ctr, Div Surg Med, Dept Cardiothorac Surg, IL-84101 Beer Sheva, Israel
[4] Ben Gurion Univ Negev, Fac Hlth Sci, IL-8410501 Beer Sheva, Israel
[5] Soroka Univ Med Ctr, Div Internal Med, IL-84101 Beer Sheva, Israel
[6] Ben Gurion Univ Negev, Med Sch Int Hlth, Fac Hlth Sci, IL-8410501 Beer Sheva, Israel
[7] Soroka Univ Med Ctr, Clin Res Ctr, IL-84101 Beer Sheva, Israel
关键词
diabetes mellitus; hemoglobin A1c; coronary artery bypass grafting; mortality; MORBIDITY; MELLITUS; DISEASE; HEART;
D O I
10.3390/jcm10122739
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 +/- 1.7%, where 206 (35.6%) patients had an HbA1c <= 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c <= 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.
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页数:8
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