Key result
Cardiogenic shock, peripheral vascular disease, and prior stroke predict acute stroke after CABG in ACS.
Why the study?
CABG in ACS remains high risk and is linked to adverse outcomes, but risk factors for acute stroke in these patients remain unclear.
What are the independent predictors of acute stroke in patients undergoing CABG surgery for acute coronary syndrome?
Cohort (n=1,344)
No
What are the independent predictors of acute stroke in patients undergoing CABG surgery for acute coronary syndrome?
Cardiogenic shock, peripheral vascular disease, and previous stroke are independent predictors of acute stroke following CABG in patients with ACS, highlighting the need for careful preoperative evaluation.
Answers are grounded in this paper and cite their sources.
May inform preoperative risk stratification in ACS patients for CABG; leaves open whether mitigation reduces stroke.
Objectives Coronary artery bypass grafting (CABG) surgery in patients with acute coronary syndrome (ACS) remains a high-risk procedure and is associated with adverse outcomes. The risk factors of acute stroke in the above-mentioned patients stay unclear and some appropriate data is lacking in the literature. Thus, we aimed to investigate the predictors of acute stroke in patients undergoing CABG surgery in ACS. Methods The retrospective single-centre cohort analysis was conducted. All patients ( n = 1344) who suffered from acute coronary syndrome and underwent CABG procedure at the University hospital Cologne from June 2011 until October 2019 were included in our study. In order to find the risk factors of acute stroke after bypass surgery, patients were divided into two groups (non-stroke group ( n = 1297) and stroke group ( n = 47)). In order to even above-mentioned groups propensity score matching (PSM) analysis was performed (non-stroke group ( n = 46) and stroke group ( n = 46). Results Duration of cardiopulmonary bypass ( p = .015) and cross clamp time ( p = .006) were significantly longer in patients who suffered stroke. Perioperative myocardial infarction was significantly higher ( p = .030) in the stroke group. Likewise, the duration of intensive care unit stay ( p < .001) and in-hospital stay ( p < .001) were significantly longer in patients with stroke. However, the mortality rate did not differ significantly ( p = .131) between above-mentioned groups. Univariate and multivariate analysis showed cardiogenic shock ( p = .003), peripheral vascular disease (PVD, p = .025) and previous stroke ( p = .045) as relevant independent predictors for acute stroke after CABG procedure in patients with ACS. Conclusion Based on our findings, acute stroke after bypass surgery in patients with ACS is associated with increased mortality and adverse outcomes. Cardiogenic shock, peripheral vascular disease and previous stroke were independent predictors of stroke after CABG procedure. Therefore, preoperative evaluation of potential risk factors may be crucial to improve postoperative results.
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Krasivskyi et al. (2023) conducted a cohort in Acute coronary syndrome undergoing CABG (n=1,344). Acute stroke after CABG vs. No stroke after CABG was evaluated on Predictors of acute stroke (p=0.003). Cardiogenic shock (p=0.003), peripheral vascular disease (p=0.025), and previous stroke (p=0.045) were independent predictors of acute stroke after CABG in patients with acute coronary syndrome.
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