TY - JOUR
T1 - Stroke Following Coronary Artery Bypass Grafting
T2 - A Ten-Year Study
AU - Gardner, Timothy J.
AU - Horneffer, Peter J.
AU - Manolio, Teri A.
AU - Pearson, Thomas A.
AU - Gott, Vincent L.
AU - Baumgartner, William A.
AU - Borkon, A. Michael
AU - Watkins, Levi
AU - Reitz, Bruce A.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1985
Y1 - 1985
N2 - To identify possible risk factors for the occurrence of stroke during coronary artery bypass grafting (CABG), the cases of 3,279 consecutive patients having isolated CABG from 1974 to 1983 were reviewed. During this period, the risk of death fell from 3.9% to 2.6%. The stroke rate, however, fell initially but then rose from 0.57% in 1979 to 2.4% in 1983. Adjustment of these data for age clearly demonstrated that the risk of stroke has increased largely because of an increase in the mean age of patients undergoing CABG procedures. A case-control study involving all 56 stroke victims and 112 control patients was used to identify those risk factors significantly associated with the development of stroke in univariate analysis: increased age (63 versus 57 years in stroke patients and controls, respectively; p < 0.0001); preexisting cerebrovascular disease (20% versus 8%; p < 0.03); severe atherosclerosis of the ascending aorta (14% versus 3%; p < 0.005); protracted cardiopulmonary bypass time (122 minutes versus 105 minutes; p < 0.005); and severe perioperative hypotension (23% versus 4%; p < 0.0001). Other variables not found to correlate with postoperative stroke included previous myocardial infarction, hypertension, diabetes mellitus, lower extremity vascular disease, preoperative left ventricular function, and intraoperative perfusion techniques. Elderly patients who have preexisting cerebrovascular disease or severe atherosclerosis of the ascending aorta or who require extensive revascularization procedures have a significantly increased risk of postoperative stroke.
AB - To identify possible risk factors for the occurrence of stroke during coronary artery bypass grafting (CABG), the cases of 3,279 consecutive patients having isolated CABG from 1974 to 1983 were reviewed. During this period, the risk of death fell from 3.9% to 2.6%. The stroke rate, however, fell initially but then rose from 0.57% in 1979 to 2.4% in 1983. Adjustment of these data for age clearly demonstrated that the risk of stroke has increased largely because of an increase in the mean age of patients undergoing CABG procedures. A case-control study involving all 56 stroke victims and 112 control patients was used to identify those risk factors significantly associated with the development of stroke in univariate analysis: increased age (63 versus 57 years in stroke patients and controls, respectively; p < 0.0001); preexisting cerebrovascular disease (20% versus 8%; p < 0.03); severe atherosclerosis of the ascending aorta (14% versus 3%; p < 0.005); protracted cardiopulmonary bypass time (122 minutes versus 105 minutes; p < 0.005); and severe perioperative hypotension (23% versus 4%; p < 0.0001). Other variables not found to correlate with postoperative stroke included previous myocardial infarction, hypertension, diabetes mellitus, lower extremity vascular disease, preoperative left ventricular function, and intraoperative perfusion techniques. Elderly patients who have preexisting cerebrovascular disease or severe atherosclerosis of the ascending aorta or who require extensive revascularization procedures have a significantly increased risk of postoperative stroke.
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U2 - 10.1016/S0003-4975(10)60352-9
DO - 10.1016/S0003-4975(10)60352-9
M3 - Article
C2 - 3878134
AN - SCOPUS:0022361267
SN - 0003-4975
VL - 40
SP - 574
EP - 581
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -