The relationship between HbA1c & atrial fibrillation after off-pump coronary artery bypass surgery in diabetic patients

Objective: diabetes mellitus is recognized as a risk factor for mortality and morbidity after coronary bypass grafting. we aimed to determine the association between preoperative hemoglobin hba1c and af after isolated off-pump coronary bypass grafting (opcab). methods: the seventy-two diabetic patients undergoing isolated off-pump coronary bypass grafting were retrospectively analyzed for af. they were divided into; low (4.8-5.4%),medium (5.5-8%) and high (8.1-11.5%) groups. the three groups were compared with respect to demographic,echocardiographic,intraoperative and postoperative clinical characteristics correlation. results: three patients died during postoperative period. af occurred in 12 patients (16.6%) after surgery. the incidence of postoperative af was 15.3% in the lower,4.4% middle and 57.1% upper group. there was statistically significant correlation between preoperative hba1c and preoperative stroke,preoperative mi history,left atrial (la) size,preoperative levosimendan,preoperative clopidogrel,postoperative af,postoperative dopamine and dobutamine use,iabp,duration of extubation time,24-hour chest tube drainage,duration of icu and hospital mortality. univariate logistic regression analysis showed significant correlation between postoperative af and variables like preoperative hba1c levels,lvef<30%,history of preoperative mi,preoperative use of levosimendan,preoperative use of clopidogrel,postoperative dopamine,dobutamine adrenaline use,left atrium size,24-hour chest tube drainage and length of stay in the intensive care unit. conclusion: preoperative hba1c levels could predict the occurrence of postoperative af in diabetic patients and may entail to administer protective strategies. © 2016,professional medical publications. all rights reserved.