Predictors associated with stroke after coronary artery bypass grafting: A systematic review

Mao, Zhifeng; Zhong, Xiaonan; Yin, Junjie; Zhao, Zhihua; Hu, Xueqiang; Hackett, Maree L.

doi:10.1016/j.jns.2015.07.006

Cited by 62 publications

(57 citation statements)

References 46 publications

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“…1 For day 30 and year 1, absolute and relative frequencies; for time-to-event analysis, 1-year Kaplan-Meier estimates; for length of hospital and ICU stay, mean and SD. 2 For day 30 and year 1, relative risk; for time-to-event analysis, unadjusted hazard ratios for treatment variable from Cox proportional hazards regression; missing effect sizes either not available or not calculated; 3 Confirmatory analysis of the primary endpoint was based on the Wald test statistic; for day 30 and year 1, exact Monte Carlo estimation for χ 2 test P values; for time-to-event analysis, log-rank test P values; for DemTect scale difference, length of hospital stay and ICU stay exact Wilcoxon-Mann-Whitney test P values. 4 Technical failure of intervention can only be measured for the synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) arm.…”

Section: Resultsmentioning

confidence: 99%

“…Carotid artery stenosis is present in ≈6% to 8% of all patients undergoing CABG and is associated with an increased risk of stroke during and after CABG. 1,2 Prophylactic treatment of asymptomatic concomitant carotid artery stenosis is managed in different ways, for example, by carotid artery angioplasty and stenting (CAS) or carotid endarterectomy (CEA), either simultaneously with CABG, before CABG, or delayed after CABG (staged or reverse staged). For many years, staged or synchronous CEA has been advocated by many cardiovascular surgeons in the attempt to reduce the perioperative and long-term risk of stroke associated with carotid artery stenosis but only very few patients with this disease entity have been included in controlled clinical trials.…”

Section: Strokementioning

confidence: 99%

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Safety of Simultaneous Coronary Artery Bypass Grafting and Carotid Endarterectomy Versus Isolated Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Weimar¹,

Bilbilis²,

Rekowski³

et al. 2018

Journal of Vascular Surgery

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Background and Purpose-The optimal operative strategy in patients with severe carotid artery disease undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety and efficacy of synchronous combined carotid endarterectomy and CABG as compared with isolated CABG. Methods-Patients with asymptomatic high-grade carotid artery stenosis ≥80% according to ECST (European Carotid Surgery Trial) ultrasound criteria (corresponding to ≥70% NASCET [North American Symptomatic Carotid Endarterectomy Trial]) who required CABG surgery were randomly assigned to synchronous carotid endarterectomy+CABG or isolated CABG. To avoid unbalanced prognostic factor distributions, randomization was stratified by center, age, sex, and modified Rankin Scale. The primary composite end point was the rate of stroke or death at 30 days. Results-From 2010 to 2014, a total of 129 patients were enrolled at 17 centers in Germany and the Czech Republic.Because of withdrawal of funding after insufficient recruitment, enrolment was terminated early. At 30 days, the rate of any stroke or death in the intention-to-treat population was 12/65 (18.5%) in patients receiving synchronous carotid endarterectomy+CABG as compared with 6/62 (9.7%) in patients receiving isolated CABG (absolute risk reduction, 8.8%; 95% confidence interval, −3.2% to 20.8%; P WALD =0.12). Also for all secondary end points at 30 days and 1 year, there was no evidence for a significant treatment-group effect although patients undergoing isolated CABG tended to have better outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Strokementioning

confidence: 99%

Safety of Simultaneous Coronary Artery Bypass Grafting and Carotid Endarterectomy Versus Isolated Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Weimar¹,

Bilbilis²,

Rekowski³

et al. 2018

Journal of Vascular Surgery

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“…Various factors are associated with perioperative strokes, including advanced age, prior (21). Increased RDW is also associated the high risk of the development cryptogenic stroke, irrespectively of anemia and inflammation (22).…”

Section: Discussionmentioning

confidence: 99%

The Red Cell Distribution Width is Strong Predictor for the in-Hospital Mortality of the CABG Patients

Katlandur¹,

Özdil²,

Özbek³

et al. 2016

Acta Med Anatol

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Introduction:There are several studies about the mortality of the CABG patients with the importance of the inflammation. The aim of our study was to evaluate the relationship between RDW and in-hospital mortality in CABG patients.Methods: A total of 346 patients undergoing coronary artery bypass grafting operation were analyzed for our study. Preoperative 2 ml blood sample was put into tubes for evaluation all patients complete blood count. All patients underwent same anesthesia protocol. The type of CABG procedure (off-pump vs on-pump CABG) was determined by the operation team. Results:There was ten patients died in-hospital period (Group 1) and three hundred and thirty-six patients lived during in hospital follow up (Group 2). WBC (10.8 ± 5.2 x 103 vs 7.9 ± 2.2 x 103 p: 0.04), Neutrophil (7.3 ± 3 x 103 vs 5.1 ± 2 x 103 p: 0.03), N/L Ratio (4.8 ± 2.6 % vs 2.7 ± 1.6 % p: 0.01) and RDW (14.8 ± 1.6 % vs 13.9 ± 6.6 %, p: 0.002) values were higher in group 1 than group 2, respectively. A logistic multivariate regression analysis showed that only RDW (OR 1.860, 95% CI 1.105-3.132; p: 0.02) was an independent predictor of the development of mortality in-hospital period in CABG patients. Conclusion:To our knowledge, this is the first report of an association between RDW and the development postoperative mortality in CABG patients. Keywords:Red cell distribution width, In-Hospital mortality, Coronary artery bypass grafting. Received: 02.03.2016 Accepted: 08.04.2016 doi: 10.5505/actamedica.2016 AbstractThe Red Cell Distribution Width is Strong Predictor for the in-Hospital Mortality of the CABG Patients

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“…It is associated with up to 5.5-fold increased risk of stroke (9,31). Postoperative atrial fibrillation is the most consistent independent variable for stroke after CABG (42). New onset of perioperative atrial fibrillation has also been associated with an increased long-term (within 1 year) risk of subsequent stroke in patients with cardiac or non-cardiac surgery (9,43).…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Approach to Risk Management of Perioperative Stroke

Chiao¹,

Zuo²

2015

J Anesth Perioper Med

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Predictors associated with stroke after coronary artery bypass grafting: A systematic review

Cited by 62 publications

References 46 publications

Safety of Simultaneous Coronary Artery Bypass Grafting and Carotid Endarterectomy Versus Isolated Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Safety of Simultaneous Coronary Artery Bypass Grafting and Carotid Endarterectomy Versus Isolated Coronary Artery Bypass Grafting: A Randomized Clinical Trial

The Red Cell Distribution Width is Strong Predictor for the in-Hospital Mortality of the CABG Patients

Approach to Risk Management of Perioperative Stroke

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