Risk Factors For Recurrent Stroke After Coronary Artery Bypass Grafting

Patients with a history of stroke who underwent CABG at Beijing An Zhen hospital from January 2007 to July 2010 were selected (n = 430), and divided into two groups according to the occurrence of postoperative stroke. Pre-operative and post-operative data were retrospectively collected and analyzed by univariate and multivariate logistic regression analyses.Thirty-two patients (7.4%) suffered post-operative stroke. Univariate analysis identified several statistically significant risk factors in the post-operative stroke group, including pre-surgical left ventricular ejection fractions (LVEF) ≤50%, on-pump surgery, post-operative atrial fibrillation (AF), and hypotension. Multivariable analysis identified 4 independent risk factors for recurrent stroke: unstable angina (odds ratio (OR) = 2.95, 95% CI: 1.05-8.28), LVEF ≤50% (OR = 2.77, 95% CI: 1.23-6.27), AF (OR = 4.69, 95% CI: 1.89-11.63), and hypotension (OR = 2.55, 95% CI: 1.07-6.04).Unstable angina, LVEF ≤50%, post-operative AF, and post-operative hypotension are independent risk factors of recurrent stroke in CABG patients with a previous history of stroke.Coronary artery bypass grafting (CABG) is an effective surgical therapy for coronary artery disease (CHD). However, the occurrence of stroke after CABG remains one of the most detrimental complications [1]. Due to improved surgical advances coupled with an increasing patient age, more patients with ≥1 co-morbidities are electing to undergo CABG. Included in this list of co-morbidities are an increasing number of patients with a history of stroke. Furthermore, atherosclerosis is a systemic disorder occurring throughout the vascular tree. Therefore, patients undergoing CABG are likely to show the concomitant occurrence of severe atherosclerosis in the carotid or cranial arteries, which often complicates the surgery.The reported incidence of stroke after CABG ranges from 1 to 5% [2]. The occurrence of stroke after CABG accounts for higher hospital mortality, longe