Determination of the value of glycated hemoglobin HbA(1c) and fructosamine in assessing the risk of perioperative complications after cardiac surgery in patients with type 2 diabetes

INTRODUCTION: Patients with diabetes have a worse postoperative course and longer length of hospital stay after surgery. A good indicator of proper long-term (3 months) glycemic control is glycated hemoglobin (HbA(1c)), and fructosamine in the short term (2–3 weeks). AIM: To determine the degree of glycemic control evaluated preoperatively by HbA(1c) and/or fructosamine influence on the postoperative course of patients with diabetes undergoing coronary artery bypass grafting (CABG) in 2014–2015. MATERIAL AND METHODS: Before the operation HbA(1c) (N < 7.0) and fructosamine (N < 280 µmol/l) were measured and depending on the results the respondents were divided into 4 groups: group I (n = 46) – normal both parameters; group II (n = 22) – high both values; group III (n = 4) – normal fructosamine/HbA(1c) high; group IV (n = 33) – high HbA(1c)/fructosamine normal. Statistical analysis was performed using the t-test assuming p < 0.05 to be statistically significant. RESULTS: One hundred and five patients were treated by CABG/OPCAB (39 female, 66 males). The mean age was 65.7 ±7.3, HbA(1c): 7.23 ±1.2%, fructosamine: 261.8 ±43.8. There was no difference in the incidence of other postoperative complications between the two groups. CONCLUSIONS: Glycated hemoglobin and fructosamine levels to a similar extent define the risk of perioperative complications in patients undergoing cardiac surgery. In patients in whom there is a need to quickly compensate for elevated blood glucose consider enabling determination of fructosamine.