Research article
Risk Factors For Recurrent Stroke After Coronary Artery Bypass Grafting
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* Corresponding author: Qin-Jun Yu ldjbio@qq.com
1 Department of Neurology, Beijing An Zhen Hospital of the Capital Medical University, Beijing, China
2 Department of Cardiac Surgery, Beijing An Zhen Hospital of the Capital Medical University, Beijing, China
3 Department of Anesthesiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academic Medical Science and Peking Union Medical College, Beijing, China
Journal of Cardiothoracic Surgery 2011, 6:157 doi:10.1186/1749-8090-6-157
Published: 23 November 2011Abstract
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.