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Published on: February 23, 2016

Risk of stroke after coronary artery bypass grafting: effect of age and comorbidities

Charlotte Mérie1, Lars Køber, Peter Skov Olsen

  • 1Department of Cardiology, Copenhagen University Hospital, Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. c.merie@mail.dk

Stroke
|October 29, 2011
PubMed

Insights

Stroke risk after coronary artery bypass grafting (CABG) increases with age, but the rise is moderate. Age alone should not be the sole reason to deny elderly patients CABG surgery.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Public Health

Background:

  • Stroke is a known complication of coronary artery bypass grafting (CABG).
  • The average age of patients undergoing CABG has increased.
  • Concomitant therapies in CABG patients have also evolved.

Purpose of the Study:

  • To re-evaluate the risk of stroke following coronary artery bypass grafting (CABG).
  • To assess how age and other factors influence stroke risk post-CABG.

Main Methods:

  • A cohort of 25,159 patients undergoing isolated CABG from 1997-2006 was identified from the Danish National Hospital Register.
  • Data on stroke, comorbidities, and medications were collected.
  • Regression models were used to determine stroke risk factors.

Main Results:

  • Overall stroke incidence was 7.6% (1901 patients), with 2.0% (477 patients) occurring within 30 days post-CABG.
  • Stroke risk within 30 days increased with age, with hazard ratios (HR) ranging from 1.7 for ages 60-64 to 3.0 for ages ≥80, compared to <60.
  • Previous stroke (HR 4.2), diabetes (HR 1.3), hypertension (HR 1.4), peripheral vascular disease (HR 1.6), and renal failure (HR 1.7) were significant risk factors. Statins (HR 0.8) and clopidogrel (HR 0.6) showed a protective effect.

Conclusions:

  • The increase in stroke risk with age after CABG is moderate.
  • The relationship between advanced age (over 70) and stroke risk post-CABG is uncertain.
  • Age alone is a debatable reason to withhold CABG from elderly patients.
Abstract

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