Key result
Severe carotid artery stenosis linked to an 8% risk of postoperative stroke after CABG.
Why the study?
To evaluate the role of severe CAS in predicting stroke after CABG and assess the efficacy of carotid artery stenting in preventing postoperative stroke in a Chinese cohort.
Does severe carotid artery stenosis predict postoperative stroke, and does carotid artery stenting prevent postoperative stroke in patients undergoing CABG?
Cohort (n=1,799)
No
Does severe carotid artery stenosis predict postoperative stroke, and does carotid artery stenting prevent postoperative stroke in patients undergoing CABG?
Severe carotid artery stenosis is an independent risk factor for postoperative stroke after CABG, but prophylactic carotid artery stenting does not appear to significantly reduce this risk.
Answers are grounded in this paper and cite their sources.
Severe carotid stenosis associated with post-CABG stroke; observational data leave open whether prophylactic stenting reduces risk.
Current guidelines give priority to surgical treatment of carotid artery stenosis (CAS) before coronary artery bypass grafting (CABG), especially in symptomatic patients. Carotid artery stenting is an alternative treatment for narrowing of the carotid arteries. This study sought to demonstrate the role of severe CAS in predicting stroke after CABG and assess the efficacy of carotid artery stenting in preventing postoperative stroke in a Chinese cohort. From 2015 to 2021, 1799 consecutive patients undergoing isolated CABG surgery were retrospectively recruited in a Chinese cohort. The predictive value of severe CAS in postoperative stroke and carotid stenting in preventing postoperative stroke was statistically analyzed. The incidence of postoperative stroke was 1.67%. The incidence of CAS with stenosis ≥ 50% and ≥ 70% was 19.2% and 6.9%. After propensity matching, the incidence of stroke was 8.0% in the severe CAS group and 0% in the non-severe CAS group. We successfully established an optimal predictive nomogram for predicting severe CAS in patients undergoing CABG. Carotid artery stenting was found ineffective in preventing postoperative stroke. The present study provides the incidence of CAS and postoperative stroke in a Chinese cohort, identifies severe CAS as an independent risk factor for postoperative stroke after CABG, constructs a nomogram predicting the incidence of severe CAS, and evaluates the effectiveness of carotid artery stenting in preventing postoperative stroke after CABG.
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Chen et al. (2023) conducted a cohort in Coronary artery disease requiring isolated coronary artery bypass grafting (n=1,799). Severe carotid artery stenosis (exposure) vs. Non-severe carotid artery stenosis was evaluated on Postoperative stroke (p=0.028). Severe carotid artery stenosis significantly increased the risk of postoperative stroke after coronary artery bypass grafting, with an 8.0% incidence compared to 0% in propensity-matched controls.
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