The objective of the present study was to assess the risk factors for stroke in patients
undergoing coronary artery bypass grafting (CABG) surgery. We conducted a nested case-control
study from a 9-year, prospective hospitalization cohort (n = 6245). Inclusion in the
cohort included CABG between October 1993 and June 2002. Exclusion criteria included
any other simultaneously performed surgery. Cases were defined as patients who underwent
CABG and experienced a stroke (171 cases, 2.7% of the total), and controls were patients
who underwent CABG without a stroke. Cases were matched to controls at a ratio of
1:3 (513 controls). The 39 predictor variables were pump time, body surface area,
creatinine, previous percutaneous transcoronary angioplasty (PTCA), clamp time, coronary
perfusion time, previous cardiac surgeries, hypertension, race, sex, previous myocardial
infarction, family history of coronary disease, history of cerebrovascular disease,
preoperative neurologic disease, pulmonary hypertension, aortic disease, previous
intervention within 30 days, angina history, bleeding history, previous vascular surgery,
diabetes, age, myocardial findings, chronic obstructive pulmonary disease, New York
Heart Association class, previous gastrointestinal disease, current vascular disease,
systemic diseases, vessels at last PTCA, PTCA result, current smoking, tobacco history,
dialysis, current anticoagulant therapy, character of operation, left ventricular
hypertrophy, hypercholesterolemia, and chronic corticosteroid therapy. There were
13 significant predictors of stroke. Regression analysis revealed 3 independent predictors
of stroke: age >70 years (odds ratio [OR], 4.61; 95% confidence interval [CI], 2.84–6.07),
poor preoperative neurologic status (OR, 4.24; 95% CI, 2.02–5.79), and previous cardiac
surgery (OR, 1.75; 95% CI, 1.05–2.91). We conclude that in patients undergoing CABG
surgery, the independent predictors for stroke, in order of risk, are age >70 years,
poor preoperative neurologic status, and previous cardiac surgery.
Keywords
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Article info
Publication history
Accepted:
June 1,
2004
Received in revised form:
June 1,
2004
Received:
May 1,
2004
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2004.06.005
Copyright
© 2004 National Stroke Association. Published by Elsevier Inc. All rights reserved.
