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09:12

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Published on: March 27, 2018

Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting

Khaldoun G Tarakji1, Joseph F Sabik, Sunil K Bhudia

  • 1Heart and Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.

JAMA
|January 27, 2011
PubMed

Insights

Stroke incidence after coronary artery bypass graft (CABG) surgery has decreased over 30 years, despite rising patient comorbidities. Postoperative strokes are more common than intraoperative ones, impacting long-term survival.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Public Health

Background:

  • Stroke is a significant complication following coronary artery bypass graft (CABG) surgery.
  • Understanding stroke timing and risk factors post-CABG is crucial for prevention and improved patient outcomes.

Purpose of the Study:

  • To analyze temporal trends in stroke occurrence after CABG.
  • To identify risk factors for stroke and their association with patient outcomes.

Main Methods:

  • A prospective study of 45,432 patients undergoing CABG between 1982 and 2009.
  • Strokes were recorded and classified as intraoperative or postoperative.
  • Outcomes and survival were compared using propensity-matched groups.

Main Results:

  • Stroke prevalence declined by 4.69% annually, despite increasing patient comorbidities.
  • 40% of strokes occurred intraoperatively and 58% postoperatively, peaking at 40 hours.
  • Older age and arteriosclerotic burden were key risk factors; stroke was associated with worse outcomes and survival.

Conclusions:

  • Stroke occurrence after CABG has decreased over three decades.
  • Postoperative stroke is more frequent than intraoperative stroke.
  • Stroke following CABG negatively impacts hospital outcomes and long-term survival.
Abstract

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