title: The relationship between HbA1c & atrial fibrillation after off-pump coronary artery bypass surgery in diabetic patients.
abstract: 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.
  
  
  CONCLUSIONS
  Preoperative HbA1c levels could predict the occurrence of postoperative AF in diabetic patients and may entail to administer protective strategies.
authors.affiliation: Suleyman Surer, Chief Resident, Diskapi Yildirim Beyazit Training & Research Hospital, Department of Cardiovascular Surgery, Diskapi-Altindag/Ankara, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Surer
authors.affiliation: Mustafa Seren, Chief Resident, Diskapi Yildirim Beyazit Training & Research Hospital, Department of Cardiovascular Surgery, Diskapi-Altindag/Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Seren
authors.affiliation: Onur Saydam, Chief Resident, Diskapi Yildirim Beyazit Training & Research Hospital, Department of Cardiovascular Surgery, Diskapi-Altindag/Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Saydam
authors.affiliation: Ali Bulut, Chief Resident, Diskapi Yildirim Beyazit Training & Research Hospital, Department of Cardiovascular Surgery, Diskapi-Altindag/Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Bulut
authors.affiliation: Ugursay Kiziltepe, Professor of Cardiovascular Surgery, Diskapi Yildirim Beyazit Training & Research Hospital, Department of Cardiovascular Surgery, Diskapi-Altindag/Ankara, Turkey.
authors.forename: Ugursay
authors.initials: U
authors.lastname: Kiziltepe
keywords: Atrial fibrillation; HbA1c; Off-pump coronary surgery