Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study

Summary

This retrospective cohort study investigated preoperative albumin-corrected anion gap (ACAG) as a predictor of mortality in patients undergoing coronary artery bypass grafting. The authors found that ACAG emerged as an independent risk factor for both in-hospital and long-term mortality, with an ACAG ≥16.0 mmol/L associated with a 2.7-fold increased risk of in-hospital death. The findings suggest that elevated ACAG may reflect severe coronary stenosis and cardiac dysfunction, potentially triggering postoperative systemic inflammation and microcirculation complications.

UK applicability

The findings may be applicable to UK cardiac surgery practice, as ACAG is a readily measurable preoperative laboratory parameter that could inform risk stratification in CABG candidates. However, validation in UK populations and alignment with National Institute for Health and Care Excellence guidance on perioperative assessment would be necessary before clinical implementation.

Key measures

Preoperative albumin-corrected anion gap (mmol/L); in-hospital mortality (odds ratio); 4-year mortality (hazard ratio); receiver operating characteristic curves; Kaplan-Meier survival curves

Outcomes reported

The study examined the association between preoperative albumin-corrected anion gap (ACAG) and in-hospital and 4-year mortality in patients undergoing coronary artery bypass grafting. Survival curves and multivariate regression models were used to determine ACAG's independent predictive value for mortality risk.

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