title: Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery.
abstract: Glycated hemoglobin (HbA1c) is a suspected risk factor for sternal wound infection (SWI) after CABG.
  
  
  
  Data on preoperative HbA1c and SWI were available in 2,130 patients undergoing isolated CABG from the prospective E-CABG registry. SWI occurred in 114 (5.4%). Baseline HbA1c was significantly higher in patients with SWI (mean, 54±17 vs. 45±13 mmol/mol, P<0.0001). This difference was also observed in patients without a diagnosis of diabetes (P=0.027), in insulin-dependent diabetic (P=0.023) and non-insulin-dependent diabetic patients (P=0.034). In the overall series, HbA1c >70 mmol/mol (NGSP units, 8.6%) was associated with the highest risk of SWI (20.6% vs. 4.6%; adjusted OR, 5.01; 95% CI: 2.47-10.15). When dichotomized according to the cut-off 53 mmol/mol (NGSP units, 7.0%) as suggested both for diagnosis and optimal glycemic control of diabetes, HbA1c was associated with increased risk of SWI in the overall series (10.6% vs. 3.9%; adjusted OR, 2.09; 95% CI: 1.24-3.52), in diabetic patients (11.7% vs. 5.1%; adjusted OR, 2.69; 95% CI: 1.38-5.25), in patients undergoing elective surgery (9.9% vs. 2.7%; adjusted OR, 2.09; 95% CI: 1.24-3.52) and in patients with bilateral mammary artery grafts (13.7% vs. 4.8%; adjusted OR, 2.35; 95% CI: 1.17-4.69).
  
  
  
  Screening for HbA1c before CABG may identify untreated diabetic patients, as well as diabetic patients with suboptimal glycemic control, at high risk of SWI.
authors.affiliation: Division of Cardiac Surgery, Ospedali Riuniti.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatti
authors.forename: Andrea
authors.initials: A
authors.lastname: Perrotti
authors.forename: Daniel
authors.initials: D
authors.lastname: Reichart
authors.forename: Luca
authors.initials: L
authors.lastname: Maschietto
authors.forename: Francesco
authors.initials: F
authors.lastname: Onorati
authors.forename: Sidney
authors.initials: S
authors.lastname: Chocron
authors.forename: Magnus
authors.initials: M
authors.lastname: Dalén
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faggian
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein
authors.forename: Aniello
authors.initials: A
authors.lastname: Pappalardo
authors.forename: Daniele
authors.initials: D
authors.lastname: Maselli
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dominici
authors.forename: Saverio
authors.initials: S
authors.lastname: Nardella
authors.forename: Antonino S
authors.initials: AS
authors.lastname: Rubino
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.forename: Francesco
authors.initials: F
authors.lastname: Santini
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicolini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gherli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.forename: Tuomas
authors.initials: T
authors.lastname: Tauriainen
authors.forename: Eeva-Maija
authors.initials: EM
authors.lastname: Kinnunen
authors.forename: Vito G
authors.initials: VG
authors.lastname: Ruggieri
authors.forename: Matteo
authors.initials: M
authors.lastname: Saccocci
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000097:blood* / Q000601:surgery; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013249:Sternum; D013530:Surgical Wound Infection / Q000097:blood*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human