Related Experiment Video
Updated: May 10, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Preoperative hematocrit concentration and the risk of stroke in patients undergoing isolated coronary-artery bypass
Khaled M Musallam1, Faek R Jamali, Frits R Rosendaal
1Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut 1107 2020, Lebanon ; Angelo Bianchi Bonomi Haemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, 20122 Milan, Italy.
Insights
Low preoperative hematocrit concentration increases stroke risk after coronary artery bypass grafting (CABG). Managing low hematocrit may reduce this serious complication in patients undergoing CABG surgery.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Hematology
Background:
- Stroke is a serious complication following isolated coronary artery bypass grafting (CABG).
- Identifying and managing risk factors for post-CABG stroke is crucial for improving patient outcomes.
- Preoperative hematocrit concentration is a potential modifiable risk factor.
Purpose of the Study:
- To assess the association between preoperative hematocrit concentration and 30-day stroke incidence after isolated CABG.
- To determine if lower hematocrit levels predict an increased risk of stroke.
Main Methods:
- Retrospective analysis of 2,313 patients undergoing isolated CABG.
- Multivariate logistic regression used to evaluate the adjusted effect of preoperative hematocrit on stroke.
- Analysis considered potential confounders and intraoperative transfusion use.
Main Results:
- 43 patients (1.9%) experienced stroke within 30 days post-CABG.
- Each 1% decrease in preoperative hematocrit was associated with a 7% increased odds of stroke (OR 1.07).
- Stroke risk exceeded 2% for hematocrit <37% in men and <38% in women, with a more pronounced effect in men.
Conclusions:
- Low preoperative hematocrit concentration is an independent risk factor for stroke after isolated CABG.
- Screening and management of patients with low hematocrit may mitigate postoperative stroke risk.
- Findings suggest targeted interventions for patients with low hematocrit undergoing CABG.
Abstract:
Background. Identification and management of risk factors for stroke following isolated coronary artery bypass grafting (CABG) could potentially lower the risk of such serious morbidity. Methods. We retrieved data for 30-day stroke incidence and perioperative variables for patients undergoing isolated CABG and used multivariate logistic regression to assess the adjusted effect of preoperative hematocrit concentration on stroke incidence. Results. In 2,313 patients (mean age 65.9 years, 73.6% men), 43 (1.9%, 95% CI: 1.4-2.5) developed stroke within 30 days following CABG (74.4% within 6 days). After adjustment for a priori defined potential confounders, each 1% drop in preoperative hematocrit concentration was associated with 1.07 (95% CI: 1.01-1.13) increased odds for stroke (men, OR: 1.08, 95% CI: 1.01-1.16; women, OR: 1.02, 95% CI: 0.91-1.16). The predicted probability of stroke for descending preoperative hematocrit concentration exceeded 2% for values <37% (<37% for men (adjusted OR: 2.39, 95% CI: 1.08-5.26) and <38% for women (adjusted OR: 2.52, 95% CI: 0.53-11.98), with a steeper probability increase noted in men). The association between lower preoperative hematocrit concentration and stroke was evident irrespective of intraoperative transfusion use. Conclusion. Screening and management of patients with low preoperative hematocrit concentration may alter postoperative stroke risk in patients undergoing isolated CABG.
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management