Poor blood sugar control before CABG Increases Mortality in diabetics: Study

The researchers analyzed the veteran data and included a total of 16 190 patients with diabetes and isolated CABG (2006–2018). They were divided into 4 groups (I: HbA1c <6.5%, II: HbA1c 6.5–8, III 8–10% and IV: HbA1c >10%). They used the multivariable Cox proportional hazards model to evaluate the association of pre-operative HbA1c and long-term survival and reported in hazards ratio (HR). They modelled the cumulative incidence of secondary end-points [myocardial infarction (MI) and repeat revascularization (percutaneous intervention)] for each group as competing events with cause-specific Cox proportional hazards models. The researchers reviewed the follow-up data of nearly 6 years.

Key findings of the study were:

• Upon analysis, they noted that the patients with HbA1c >10% were the youngest (mean age 60.9 years) and had high rates of Insulin dependence (78%).
• In patients with HbA1c >10%, they observed improvements of levels in 76%.
• Further, they found that pre-operative HbA1c > 8% is associated with the increased risk of mortality and adverse cardiac events in patients undergoing CABG.
• They wrote, "Compared to patients with HbA1c <8%, HbA1c 8–10% and >10% were associated with increased MI (HR 1.24 and HR 1.39, respectively) and need for reintervention (HR 1.20 and HR 1.24, respectively)."

The authors concluded, "In patients undergoing CABG, pre-operative HbA1c >8% is associated with the increased risk of mortality and adverse cardiac events."

For further information:

DOI: https://doi.org/10.1093/ejcts/ezab180