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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
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Renal dysfunction and long-term risk of ischemic and hemorrhagic stroke following coronary artery bypass grafting

Martin J Holzmann1, Erik Ahlbäck, Anders Jeppsson

  • 1Department of Emergency Medicine, Karolinska University Hospital and Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden.

International Journal of Cardiology
|December 11, 2012
PubMed

Insights

Patients with impaired kidney function face a higher risk of stroke after coronary artery bypass grafting (CABG). This study highlights the importance of renal health in cardiovascular surgery outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Neurology

Background:

  • Renal dysfunction is a known risk factor for mortality and myocardial infarction post-coronary artery bypass grafting (CABG).
  • The association between renal dysfunction and long-term stroke risk following CABG remains under-investigated.

Purpose of the Study:

  • To investigate the relationship between varying degrees of renal dysfunction and the long-term risk of stroke after primary isolated CABG.
  • To assess if the risk of stroke differs between ischemic and hemorrhagic types in patients with renal dysfunction.

Main Methods:

  • A cohort of 29,057 patients undergoing primary isolated CABG from 2000-2008 in Sweden was analyzed.
  • Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease equation.
  • Hazard ratios (HR) were computed to determine stroke risk in relation to eGFR, adjusting for relevant factors.

Main Results:

  • An increased risk of stroke was observed with declining eGFR levels (eGFR 45-60, 30-45, and 15-30 mL/min/1.73 m²).
  • Adjusted HR for stroke increased significantly with lower eGFR compared to eGFR >60 mL/min/1.73 m².
  • The risk of hemorrhagic stroke was notably higher than ischemic stroke in patients with eGFR 15-45 mL/min/1.73 m².

Conclusions:

  • Renal dysfunction is significantly associated with an elevated long-term risk of stroke following primary isolated CABG.
  • The impact of renal dysfunction on stroke risk is comparable between men and women.
Abstract

Keywords:
KidneyPrognosisStrokeSurgery

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