Is there a Predictive Value of Hemoglobin A1C for Complications of Cardiac Surgery?

Objective: To investigate the effect of preoperative hemoglobin A1c levels for the complications of cardiac surgery.

Study Design:   Meta-analysis. Place of Study: Siyami Ersek Chest and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.

Methodology: PubMed, Scopus, Web of Science and Ovid electronic databases were used. The studies were included the recorded preoperative levels of hemoglobin A1C and postoperative complications developed after cardiac surgery. Results of the studies were evaluated, based on either random or fixed effect model, according to presence of heterogeneity (I2>25%).

Results: In total, 2,312 articles were obtained. After reviewing the articles, 33 articles covering 3500 patients meeting the inclusion criteria were included. The results pointed out that there was a relationship between preoperative hemoglobin A1c levels and mediastinitis, stroke, pneumonia, sepsis, renal failure and mortality. Heterogeneity was observed for myocardial infarction, atrial fibrillation and multiorgan failure (I2 >25%).

Conclusion: Preoperative hemoglobin A1C levels were associated with development of mediastinitis, stroke, pneumonia, sepsis, renal failure and mortality after cardiac surgery. Key Words: Hemoglobin A1C, Cardiac surgery, Complication, Meta-analysis.