Does preoperative homocysteine level influence the postoperative period in diabetic or non-diabetic patients undergoing coronary artery bypass grafting?

Background: Elevated homocysteine (Hcy) has been linked to endothelial dysfunction and adverse cardiovascular outcomes. However, its specific role in patients with type 2 diabetes mellitus (T2DM) undergoing coronary artery bypass grafting (CABG) is not well established. Methods: We conducted a prospective analysis of 66 patients (27 with T2DM, 39 controls) who underwent elective CABG. Clinical, biochemical, and postoperative data were collected for all participants. Spearman’s correlation assessed associations between Hcy and laboratory parameters, while univariable and multivariable logistic regression examined relationships with complications. Results: Preoperative median Hcy levels were similar in T2DM patients and controls (12.6 vs. 12.1 µmol/L, p = 0.24). In the total cohort, Hcy showed positive correlations with triglycerides (r = 0.39, p = 0.0018), C-peptide (r = 0.33, p = 0.0086), and CRP (r = 0.29, p = 0.0210), and a negative correlation with HDL cholesterol (r = –0.31, p = 0.0149). Higher Hcy levels were significantly associated with acute kidney injury (AKI) or exacerbation of chronic kidney disease (CKD) after CABG (b = 7.14, SE = 2.11, b⁎ = 0.40, p = 0.0013). Conclusion: Elevated preoperative Hcy levels were associated with postoperative renal complications after CABG. Therefore, Hcy may serve as a potential biomarker of AKI or exacerbation of CKD after CABG.