Risk factors for recurrent stroke after coronary artery bypass grafting

J Cardiothorac Surg. 2011 Nov 23:6:157. doi: 10.1186/1749-8090-6-157.

Abstract

Objectives: Preventing stroke after coronary artery bypass grafting (CABG) remains a therapeutic goal, due in part to the lack of identifiable risk factors. The aim of this study, accordingly, was to identify risk factors in CABG patients with a previous history of stroke.

Methods: Patients with a history of stroke who underwent CABG at Beijing An Zhen hospital from January 2007 to July 2010 were selected (n = 430), and divided into two groups according to the occurrence of postoperative stroke. Pre-operative and post-operative data were retrospectively collected and analyzed by univariate and multivariate logistic regression analyses.

Results: Thirty-two patients (7.4%) suffered post-operative stroke. Univariate analysis identified several statistically significant risk factors in the post-operative stroke group, including pre-surgical left ventricular ejection fractions (LVEF) ≤50%, on-pump surgery, post-operative atrial fibrillation (AF), and hypotension. Multivariable analysis identified 4 independent risk factors for recurrent stroke: unstable angina (odds ratio (OR) = 2.95, 95% CI: 1.05-8.28), LVEF ≤50% (OR = 2.77, 95% CI: 1.23-6.27), AF (OR = 4.69, 95% CI: 1.89-11.63), and hypotension (OR = 2.55, 95% CI: 1.07-6.04).

Conclusion: Unstable angina, LVEF ≤50%, post-operative AF, and post-operative hypotension are independent risk factors of recurrent stroke in CABG patients with a previous history of stroke.

Publication types

  • Comparative Study

MeSH terms

  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / epidemiology
  • China / epidemiology
  • Coronary Artery Bypass / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypotension / complications*
  • Hypotension / epidemiology
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Ischemia / surgery*
  • Postoperative Complications
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology