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Predictors and Outcomes of Stroke After Isolated Coronary Artery Bypass Grafting. A Single-Center Experience in

Vincent J Kroeze1, Jules R Olsthoorn2, Albert H M van Straten2

  • 1Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Journal of Cardiothoracic and Vascular Anesthesia
|May 6, 2023
PubMed

Insights

Stroke after coronary artery bypass grafting (CABG) is a serious complication. Key predictors include age, peripheral arterial disease, and the year of surgery, impacting both early and long-term survival.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Public Health

Background:

  • Stroke is a significant complication following cardiac surgery, despite advancements in perioperative care.
  • Identifying predictors of stroke is crucial for improving patient outcomes after coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To determine the independent predictors of postoperative stroke in a large cohort of patients undergoing isolated CABG.
  • To assess the impact of postoperative stroke on early and late mortality.

Main Methods:

  • Retrospective analysis of patient data from a single center (Catharina Hospital, Eindhoven).
  • Inclusion of all patients who underwent isolated CABG between January 1998 and February 2019.
  • Logistic and Cox regression analyses to identify stroke predictors and their association with mortality.

Main Results:

  • A total of 20,582 patients underwent CABG; 142 (0.7%) experienced postoperative stroke.
  • Stroke incidence declined over the study period.
  • Independent predictors of stroke included age, peripheral arterial disease, reexploration for bleeding, perioperative myocardial infarction, and year of surgery.
  • Postoperative stroke was associated with significantly higher 30-day mortality (20.4% vs 1.8%) and worse long-term survival.

Conclusions:

  • Postoperative stroke following CABG is linked to substantial early and late mortality.
  • Age, peripheral vascular disease, and the year of surgery are significant independent predictors of stroke after CABG.
Abstract

Keywords:
coronary artery bypass graftingpostoperative strokesurvival analysis

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