• Thomas Alserius, Russell E Anderson, Niklas Hammar, Tobias Nordqvist, and Torbjörn Ivert.
• Department of Cardiothoracic Surgery and Anaesthesiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
• Scand. Cardiovasc. J. 2008 Dec 1; 42 (6): 392-8.

ObjectiveTo evaluate if glycosylated haemoglobin 1 (HbA1c) was associated with increased risk of infection and mortality after coronary artery bypass grafting (CABG).DesignProspective observational study. Preoperative HbA1c concentrations were correlated to outcome in patients followed for an average of 3.5 years after CABG.ResultsHbA1c was > or =6% in 68% of 161 patients with diabetes mellitus (DM) and in 3% of 444 patients without DM. Superficial sternal wound infection was observed in 13.9% if HbA1c > or =6% versus in 5.5% if <6% (p=0.007). Mediastinitis occurred in 4.9% if HbA1c > or =6% and in 2.1% if HbA1c <6% (p=0.20) (Hazard ratio (HR) 1.9, 95% CI 0.6-5.9). Follow-up mortality was 18.9% in patients with HbA1c > or =6% compared to 4.1% if HbA1c <6% (p<0.001) with HR 5.4, (95% CI 3.0-10.0) after multivariable adjustment. The risk of death was similar regardless of DM diagnosis.ConclusionsHbA1c > or =6% was associated with an increased risk of postoperative superficial sternal wound infections and a trend for higher mediastinitis rate and significantly higher mortality three years after CABG.

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