%0 Journal Article
%T The prevalence of elevated hemoglobin A1c in patients undergoing coronary artery bypass surgery
%A Milo Engoren
%A Robert H Habib
%A Anoar Zacharias
%A Thomas A Schwann
%A Christopher J Riordan
%A Samuel J Durham
%A Aamir Shah
%J Journal of Cardiothoracic Surgery
%D 2008
%I BioMed Central
%R 10.1186/1749-8090-3-63
%X All patients undergoing coronary artery bypass surgery had hemoglobin A1c levels determined immediately preoperatively. Proportions were used to describe the number of patients with elevated levels. Linear regression and receiver operator characteristic curves were used to evaluate the accuracy of risk factors to identify patients with elevated levels.83 of 87 (95%) diabetic patients had elevated A1c levels (≡ 6.0%), with 55 of 87 (63%) having inadequate control 每 A1c levels ≡ 7.0. 93 of 163 (57%) non-diabetic patients had elevated A1c levels (≡ 6.0%), with 19 (12%) having levels ≡ 7.0%. Risk factors for diabetes mellitus poorly predicted which patient had elevated A1c levels.The prevalence of elevated hemoglobin levels in patients undergoing coronary artery bypass surgery is high and routine measurement should be done to permit institution of lifestyle modifications and medication changes that decrease complications and death from diabetes mellitus.The prevalence of diabetes mellitus(DM) is increasing in the United Sates and has become a major public health issue [1]. Nearly 21 million Americans 每 7% of the population 每 have DM, including over 6 million who are undiagnosed [1]. Additionally, there are 41 million Americans with pre-diabetes [2]. DM is a risk factor for coronary artery disease and its presence portends a worse outcome 每 both short and long term 每 in patients undergoing coronary artery bypass surgery [3,4]. Following recent studies that have shown the benefits of tight glycemic control in both diabetic and non-diabetic patients [5,6], we instituted protocols designed for tight glycemic control in both the intensive care unit and the stepdown unit. We noticed, however, that some patients without any history of DM were still requiring antiglycemic therapy upon discharge and that other patients with a history of DM remained poorly controlled despite resumption of their usual antiglycemic medicines and eating a hospital provided diabetic diet. To better h
%U http://www.cardiothoracicsurgery.org/content/3/1/63