Why the study?
Only sparse epidemiological data were available regarding the risk of ischemic stroke after coronary artery bypass surgery.
Does coronary artery bypass graft surgery increase the risk of ischemic stroke in patients with acute myocardial infarction?
Does coronary artery bypass graft surgery increase the risk of ischemic stroke in patients with acute myocardial infarction?
CABG performed after acute myocardial infarction is associated with an increased risk of ischemic stroke, highlighting the importance of optimizing modifiable risk factors and utilizing evidence-based therapies like statins and P2Y12 inhibitors.
CABG after AMI was associated with higher ischemic stroke rates; leaves open whether this reflects causation or residual confounding.
Only sparse epidemiological data are available regarding the risk of ischemic stroke (IS) after coronary artery bypass surgery (CABG). Here we aimed to describe the incidence and predictors of IS associated with CABG performed after acute myocardial infarction (AMI), as well as trends over time. We analyzed data for 248,925 unselected AMI patients. We separately analyzed groups of patients who underwent CABG early or late after the index infarction. IS incidence rates per year at risk were 15.8% (95% confidence interval, 14.5-17.1) and 10.9% (10.6-11.2), respectively, among patients with and without CABG in the early cohort, and 4.0% (3.5-4.5) and 2.3% (2.2-2.3), respectively, among patients with and without CABG in the late cohort. Predictors of post-AMI IS included prior IS, CABG, prior atrial fibrillation, prior hemorrhagic stroke, heart failure during hospitalization, older age, diabetes mellitus, and hypertension. Reduced IS risk was associated with use of statins and P2Y12 inhibitors. IS incidence markedly decreased among patients who did not undergo CABG, while no such reduction over time occurred among those who underwent CABG. This emphasizes the need to optimize modifiable risk factors and to consistently use treatments that may reduce IS risk among CABG patients.
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Åström et al. (2020) studied this question.
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