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A Meta-Analysis of elevated glycosylated hemoglobin before coronary artery bypass grafting
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  • Wenyu ZHAO,
  • Jingui XIE,
  • Zhichao Zheng,
  • Oon OOI,
  • Haidong Luo
Wenyu ZHAO
University of Science and Technology of China
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Jingui XIE
Technical University of Munich
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Zhichao Zheng
Singapore Management University
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Oon OOI
National University Hospital
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Haidong Luo
National University Hospital
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Abstract

Background It is inconclusive the association between elevated preoperative glycosylated hemoglobin (HbA1c) and clinical outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods A search was conducted on the database of PubMed, Scopus, and Cochrane Library databases to identify potentially relevant articles. We extracted the reported odds ratio (OR) or the incidence of mortality, stroke, renal failure (RF), myocardial infarction (MI), deep sternal wound infection (DSWI), atrial fibrillation (AF). The OR with 95% confidence intervals (CIs) was used as the summary statistic. Results For all patients undergoing CABG, the comprehensive integration and analyses revealed that elevated preoperative HbA1c levels were associated with a significantly increased risk of stroke (OR=1.648, 95%CI 1.251-2.172, p = 0.000), RF (OR=1.752, 95%CI 1.427-2.150, p = 0.000), and DSWI (OR=2.749, 95%CI 2.018-3.744, p = 0.000) with low heterogeneity, but not related to the risk of mortality (30-day mortality: OR=1.228, 95%CI 0.890-1.694, p = 0.211; in-hospital mortality: OR=1.269, 95%CI 0.958-1.679, p = 0.096), MI (OR=1.104, 95%CI 0.699-1.745, p = 0.671), or AF (OR=0.914, 95%CI 0.785-1.064, p = 0.217) Conclusions The meta-analysis indicated that patients undergoing CABG with preoperative HbA1c higher than 6.5% might be more susceptible to stroke, RF, and DSWI.

Peer review status:UNDER REVIEW

28 Aug 2020Submitted to Journal of Cardiac Surgery
29 Aug 2020Assigned to Editor
29 Aug 2020Submission Checks Completed
06 Sep 2020Reviewer(s) Assigned
24 Sep 2020Review(s) Completed, Editorial Evaluation Pending