- Academic Editors
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†These authors contributed equally.
Background: Iron deficiency (ID) is one of the most common
micronutrient deficiencies affecting public health. Studies show that ID affects
the prognosis of patients with heart disease, including heart failure, coronary
artery disease and myocardial infarction. However, there is limited information
regarding the impact of ID on patients undergoing cardiac surgery. This study
aimed to evaluate the influence of preoperative ID on the prognosis of type 2
diabetes mellitus (T2DM) patients undergoing coronary artery bypass grafting
(CABG). Methods: In the Glycemic control using mobile-based intervention
in patients with diabetes undergoing coronary artery bypass to promote
self-management (GUIDEME) study, patients with T2DM undergoing CABG were
prospectively recruited. In this study, only those patients with preoperative
iron metabolism results were enrolled. Patients were grouped based on the
presence of preoperative ID. The primary endpoint was defined as the significant
improvement of follow-up ejection fraction (EF) compared to postoperative levels
(classified according to the 75th percentile of the change, and defined as an
improvement of greater than or equal to 5%). Univariable logistic regression was
performed to explore the potential confounders, followed by multiple adjustment.
Results: A total of 302 patients were enrolled. No deaths were observed
during the study period. A higher incidence of the primary endpoint was observed
in the ID group (25.4% vs 12.9%, p = 0.015). The postoperative and
follow-up EF were similar beween the two groups. In the regression analysis, ID
was noticed to be a strong predictor against the significant improvement of EF in
both univariable (odds ratio [OR]: 0.44, 95% confidence interval [CI]:
0.22–0.86, p = 0.017) and multivariable (OR: 0.43,
95% CI: 0.24–0.98, p = 0.043)
logistic regression. In the subgroup analysis, ID was a predictor of significant
improvement of EF in age