Evidence mapPaperPMID 41299258Full record

ArticleBMC cardiovascular disorders2025

Postoperative glycemic variability as a predictor for one-year mortality following coronary artery bypass grafting: a retrospective cohort study.

Jiasen Ma, Junjun Qin, Fengkai Mao, Changlin He, Daqing Ma, Jinpiao Zhu

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Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Jiasen MaDepartment of Anesthesiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China.
Junjun QinDepartment of Anesthesiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China.
Fengkai MaoSchool of Medicine, Hangzhou Normal University, Hangzhou, 311121, China.
Changlin HeDepartment of Anesthesiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China. hechanglin2008@163.com.
Daqing MaDepartment of Rehabilitation Children's Hospital, Perioperative and Systems Medicine Laboratory, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, 310052, China. d.ma@imperial.ac.uk.
Jinpiao ZhuDepartment of Rehabilitation Children's Hospital, Perioperative and Systems Medicine Laboratory, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, 310052, China. zhujinpiao@zju.edu.cn.

Funding

Special Fund for the Incubation of Young Clinical Scientist, the Children's Hospital of Zhejiang University School of Medicine CHZJU2024YS001the Children's Hospital of Zhejiang University School of Medicine Pre-Research Fund CHZJU2023YY006the Key Project of Medical and Health Science and Technology Plan of Zhejiang Province WKJ-ZJ-2536The National Natural Science Foundation of China 82401498The "Pioneer" and "Leading Goose" R&D Program of Zhejiang 2025C02082
6 · The paper itself

Abstract

backgroundIncreased postoperative glycemic variability (GV) has been shown to be associated with an increased risk for adverse outcomes. However, the impact of postoperative GV on the long-term mortality after cardiac surgery, particularly with regarding other associated interactive factors, remains unknown. In this study, we sought to investigate whether postoperative GV is associated with one-year mortality, and to determine whether preoperative hemoglobin A1C (HbA1C) levels or diabetes status contribute to the risk of GV-related one-year mortality following coronary artery bypass grafting (CABG).

methodsData from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database derived from 3,598 patients, who underwent their CABG surgery and subsequently admitted to the ICU between 2008 and 2019, were retrospectively analysed. Patients were categorized into two groups based on the postoperative GV levels: the GV-Low group (GV < 0.219, n = 2,399) and the GV-High group (GV ≥ 0.219, n = 1,199). Cox proportional hazards models were used to examine the association between postoperative GV and one-year mortality. Kaplan-Meier curves were used to assess cumulative survival, while restricted cubic splines (RCS) were employed to explore the relationship between postoperative GV changes and one-year mortality. Cox regression was then applied to assess the impact of postoperative GV changes on one-year mortality.

resultsThe one-year mortality rate was 4.92% following CABG. Multivariate Cox proportional hazards analysis revealed a significant association between postoperative GV and one-year mortality, with a hazard ratio of 1.273 (95% CI, 1.155-1.405) per 1-unit increase in Log-transformed GV in the unadjusted model, 1.255 (95% CI, 1.136-1.390) in the partially adjusted model, and 1.146 (95% CI, 1.035-1.269) in the fully adjusted model. The association followed a linear pattern (p-non-linearity= 0.962). In addition, the association was stronger in patients without diabetes mellitus (DM) (hazard ratio [HR], 1.318; 95% CI, 1.072-1.622) or in patients with preoperative HbA1c levels ≤ 7.0% (HR, 1.188; 95% CI, 1.039-1.357).

conclusionIncreased postoperative GV is associated with higher one-year mortality following CABG, particularly in patients without DM. These findings may offer valuable guidance for targeted strategy development to reduce mortality after cardiac surgery per se.

Indexed as

Blood GlucoseCoronary Artery BypassCoronary Artery DiseaseDiabetes MellitusGlycated HemoglobinAgedBiomarkersDatabases, FactualFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsBiomarkersBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanCoronary artery bypass grafting, CABGDiabetes mellitus, DMGlycemic variabilityHemoglobin A1C, HbA1cMIMIC-IV databaseMortality

Identifiers

PMID41299258
PMCPMC12659535

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.