Key result
Post-operative AF is linked to ~370% higher risk of recurrent stroke after CABG.
Why the study?
Preventing stroke after CABG remains a therapeutic goal due in part to the lack of identifiable risk factors in patients with previous stroke.
What are the independent risk factors for recurrent stroke in patients with a previous history of stroke undergoing coronary artery bypass grafting?
Observational (n=430)
No
What are the independent risk factors for recurrent stroke in patients with a previous history of stroke undergoing coronary artery bypass grafting?
Unstable angina, LVEF ≤50%, post-operative atrial fibrillation, and post-operative hypotension independently predict recurrent stroke in patients with a prior stroke undergoing CABG.
Answers are grounded in this paper and cite their sources.
May guide closer monitoring in high-risk prior-stroke CABG patients; hypothesis-generating and requires prospective validation.
OBJECTIVES: Preventing stroke after coronary artery bypass grafting (CABG) remains a therapeutic goal, due in part to the lack of identifiable risk factors. The aim of this study, accordingly, was to identify risk factors in CABG patients with a previous history of stroke. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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Cao et al. (2011) conducted an observational in Coronary artery disease with a previous history of stroke (n=430). Post-operative atrial fibrillation (AF) vs. Absence of post-operative atrial fibrillation was evaluated on Recurrent post-operative stroke (OR 4.69, 95% CI 1.89-11.63, p=0.001). Post-operative atrial fibrillation significantly increased the risk of recurrent stroke after coronary artery bypass grafting (OR 4.69), alongside unstable angina, LVEF ≤50%, and hypotension.
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