Predictors associated with stroke after coronary artery bypass grafting in Turkish population

Abstract

Background Objective: Postoperative stroke is a serious adverse event, a major cause of morbidity and mortality after coronary artery bypass grafting (CABG). This study is designed to determine the incidence of stroke after CABG and to identify the preoperative, intraoperative and postoperative risk factors associated with the development of a stroke.

Methods: Between January 2019 and December 2022, 1.555 CABG were performed. Retrospective analysis of the patient files revealed that 24 (1.48%) patients had stroke in the postoperative period. Variables were compared with patients without neurological deficits (n=50) who had undergone CABG. Predictors of preoperative, intraoperative and postoperative stroke were identified.

Results: The incidence of postoperative stroke was 1.48% (n=24). Mean age of these patients was 63.86 ± 8.58 years, and 59 (79.7%) were males. Chronic renal failure (p= 0.011), previous CABG (p=0.009), carotid artery disease (p=0.009), CRP levels (p=0.004) and Monocyte/Lymphocyte ratio (p=0.019) were identified as important preoperative risk factors for stroke development but there were no diffirence prevalence of age, sex, diabetes, hypertension, congestive heart failure and atrial fibrillation.

Conclusion: Five variables (chronic renal failure, prior CABD, prior carotid artery disease, preoperative CRP levels and Monocyte/Lymphocyte ratio were found as risk factors for stroke after CABG. The development of postoperative stroke is associated with multiple morbidities and increased mortality. Careful assessment and management of risk factors should be implemented to reduce this important complication after CABG.