The Effect of HbA1c Level on Gender-Specific Long-Term Morbidity and Mortality After Isolated Coronary Bypass in Poorly Controlled Diabetic Patients

Abstract

Objective: The aim of this study is to evaluate the gender specific effects of the high HbA1c levels in poorly controlled diabetic patients undergoing isolated coronary artery bypass grafting (CABG) procedure on long term morbidity, mortality and re-revascularization (2nd intervention). Methods: This study was conducted on 532 (346 (65%) males and 186 (35%) females) diabetic patients who underwent CABG procedure at a single center between January 2010 and December 2013.The patients were separated into 4 groups according to gender and preoperative HbA1c level (%). The group1 consisted of females with HBA1c level ≤7(n=46); the group 2 comprised female with HbA1c level >7(n=140); the group 3 comprised men with HbA1c level ≤7(n=117); and the group 4 comprised men with HbA1c level >7(n=229). The groups were analyzed and compared for postoperative complications and mortality. Results: No statistically significant difference was found among the groups in HbA1c levels and gender with respect to postoperative infection and mortality (p>0.05). The HbA1c level was determined to be statically significant and required the 2ndintervention (p:0.001; 95% CI: 1.249 (1.055,1.478)). Conclusion: This study suggested that there was no difference in mortality rates after CABG among the groups although the current risk calculator modules stated otherwise. However, the HbA1c levels were associated with a need for a secondary intervention on long term follow up period.