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Fructosamine as a marker for carbohydratemetabolism and its relationship with in-hospitaloutcomes after coronary artery bypass grafting

Authors: Bezdenezhnykh N.A.1, Sumin A.N.1, Bezdenezhnykh A.V.1, Osokina A.V.1, Kuz’mina A.A.1, Gruzdeva O.V.1, Barbarash O.L.1,2, 2

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases; Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
 2 Kemerovo State Medical Institution; ulitsa Voroshilova, 22a, Kemerovo, 650056, Russian Federation

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DOI: https://doi.org/10.15275/kreatkard.2017.01.04

For citation: Bezdenezhnykh N.A., Sumin A.N., Bezdenezhnykh A.V., Osokina A.V., Kuz’mina A.A., Gruzdeva O.V., Barbarash O.L. Fructosamine as a marker for carbohydrate metabolism and its relationship with in-hospital outcomes after coronary artery bypass grafting. Kreativnaya kardiologiya (Creative Cardiology, Russian journal). 2017; 11 (1): 31–44 (in Russ.). DOI: 10.15275/kreatkard.2017.01.04

Received / Accepted:  March 06, 2017 / March 16, 2017

Keywords: fructosamine glycated hemoglobin diabetes coronary artery bypass surgery postoperative complications glycemic control

Full text:  

 

Abstract

Objective. To assess the relationship between fructosamine levels, other parameters of carbohydrate metabolism and the rate of in-hospital complications after CABG in patients with type 2 diabetes.
Material and methods. 114 patients with type 2 diabetes mellitus (group 1) included in the study from the CABG Registry (708 patients undergoing CABG in 2011–2012 in cardiac surgery clinic Kemerovo). 114 patients without any documented disorders of carbohydrate metabolism (group 2) were comparable for age, gender and CABG characteristics. All patients underwent HbA1c and serum fructosamine measurement.
Results. The analysis of the in-hospital complications reported a significantly higher rate of the chest-related complications (p=0.02), primarily due to hydrothorax (p=0.005). There were no significant differences found in other complication rates. According to regression analysis markers of carbohydrate metabolism (glucose, HbA1c, fructosamine) were examined as potential predictors of in-hospital adverse events after CABG. Logistic regression didn’t reveal any associations of glucose level with postoperative complications. HbA1c was associated only with sternal wound complications (odds ratio (OR) 1.183, 95% confidence interval (CI) 1.024–1.618, p=0.033). Fructosamine was an independent predictor of sternal wound complications (OR 1.132 per 10 μmol/l increase, 95% CI 1.012–1.266, p=0.029) and chest-related complications (OR 1.747, 95% CI 1.045–2.920 for fructosamine levels ≥287.5 μmol/l, p=0.028).
Сonclusion. Serum fructosamine level is a significant predictor of the CABG complications in patients with diabetes and without diabetes.

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About Authors

  • Bezdenezhnykh Natal’ya Aleksandrovna, MD, PhD, Research Associate;
  • Sumin Aleksey Nikolaevich, MD, DM, Chief of Department;
  • Bezdenezhnykh Andrey Viktorovich, MD, PhD, Senior Research Associate;
  • Osokina Anastasiya Vyacheslavovna, MD, PhD, Senior Research Associate;
  • Kuz’mina Anastasiya Aleksandrovna, Junior Research Associate;
  • Gruzdevа Ol’ga Viktorovna, MD, DM, Chief of the Laboratory;
  • Barbarash Ol’ga Leonidovna, MD, DM, Professor, Corresponding Member of Russian Academy of Sciences, Director of Research Institute for Complex Issues of Cardiovascular Diseases, Chief of Chair of the Cardiology and Cardiovascular Surgery Department at the Kemerovo State Medical Academy of Ministry of Health of the Russian Federation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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