Can tight glucose control prevent complications in diabetic patients with high HbA1c undergoing coronary artery bypass surgery?
MURAT BAŞTOPÇU, MUSTAFA ŞİMŞEK, SEVİNÇ BAYER ERDOĞAN, HALİT ER
Introduction: High HbA1c in patients undergoing CABG is shown to be associated with increased mortality and infectious complications. Tight glucose control can reduce postoperative adverse events in diabetic patients after CABG. We investigated whether strict peroperative glucose control can prevent complications in patients with high HbA1c.
Method: Patients with known DM undergoing CABG between July and August 2020 were prospectively included. Patients operated off-pump were excluded. All patients were managed with tight glucose control with targeted blood glucose <120mg/dl. Patients were separated according to their HbA1c levels into high and low HbA1c groups. Operative outcomes and complications were recorded and compared.
Results: Mean age of included patients 61.3 ± 9.7. 17 (22.7%) patients were female. Median HbA1c was 7.7 and patients were grouped accordingly. No mortality was seen in our cohort. Postoperative infection of any cause (11.8% vs 11.8%, p=1.000), deep sternal infection (2.9% vs 2.9%, p=1.000), other complications including stroke and acute renal failure were not different between high and low HbA1c groups.
Conclusion: Tight glucose control can reduce mortality and infectious complications in diabetic patients with high HbA1c. In patients without decent glycemic control in the period leading to CABG, tight glycemic control during the perioperative management is important.
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